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Pogoda TK, Adams RS, Carlson KF, Dismuke-Greer CE, Amuan M, Pugh MJ. Risk of Adverse Outcomes Among Veterans Who Screen Positive for Traumatic Brain Injury in the Veterans Health Administration But Do Not Complete a Comprehensive Evaluation: A LIMBIC-CENC Study. J Head Trauma Rehabil 2024; 39:171-182. [PMID: 37335204 PMCID: PMC10728337 DOI: 10.1097/htr.0000000000000881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
OBJECTIVE To examine whether post-9/11 veterans who screened positive for mild traumatic brain injury (mTBI) but did not complete a Comprehensive TBI Evaluation (CTBIE) were at higher risk of subsequent adverse events compared with veterans who screened positive and completed a CTBIE. Upon CTBIE completion, information assessed by a trained TBI clinician indicates whether there is mTBI history (mTBI+) or not (mTBI-). SETTING Veterans Health Administration (VHA) outpatient services. PARTICIPANTS A total of 52 700 post-9/11 veterans who screened positive for TBI were included. The follow-up review period was between fiscal years 2008 and 2019. The 3 groups studied based on CTBIE completion and mTBI status were: (1) mTBI+ (48.6%), (2) mTBI- (17.8%), and (3) no CTBIE (33.7%). DESIGN This was a retrospective cohort study. Log binomial and Poisson regression models adjusting for demographic, military, pre-TBI screening health, and VHA covariates examined risk ratios of incident outcomes based on CTBIE completion and mTBI status. MAIN MEASURES Incident substance use disorders (SUDs), alcohol use disorder (AUD), opioid use disorder (OUD), overdose, and homelessness documented in VHA administrative records, and mortality as documented in the National Death Index, 3 years post-TBI screen. VHA outpatient utilization was also examined. RESULTS Compared with the no CTBIE group, the mTBI+ group had 1.28 to 1.31 times the risk of incident SUD, AUD, and overdose, but 0.73 times the risk of death 3 years following TBI screening. The mTBI- group had 0.70 times the risk of OUD compared with the no CTBIE group within the same period. The no CTBIE group also had the lowest VHA utilization. CONCLUSIONS There were mixed findings on risk of adverse events for the no CTBIE group relative to the mTBI+ and mTBI- groups. Future research is needed to explore the observed differences, including health conditions and healthcare utilization, documented outside VHA among veterans who screen positive for TBI.
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Affiliation(s)
- Terri K Pogoda
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, Massachusetts (Dr Pogoda); Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, Massachusetts (Drs Pogoda and Adams); VHA Rocky Mountain Mental Illness Research Education and Clinical Center, Aurora, Colorado (Dr Adams); Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon, and Epidemiology, Oregon Health and Science University-Portland State University School of Public Health, Oregon Health and Science University, Portland (Dr Carlson); Health Economics Resource Center, VA Palo Alto Health Care System, Menlo Park, California (Dr Dismuke-Greer); Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City Health Care System, Salt Lake City, Utah (Ms Amuan and Dr Pugh); and Department of Internal Medicine, Division of Epidemiology, University of Utah Spence Fox Eccles School of Medicine, Salt Lake City (Dr Pugh)
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Raver E, Retchin SM, Li Y, Carlo AD, Xu WY. Rural-urban differences in out-of-network treatment initiation and engagement rates for substance use disorders. Health Serv Res 2024. [PMID: 38456488 DOI: 10.1111/1475-6773.14299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVE To examine rural-urban disparities in substance use disorder treatment access and continuation. DATA SOURCES AND STUDY SETTING We analyzed a 2016-2018 U.S. national secondary dataset of commercial insurance claims. STUDY DESIGN This cross-sectional study examined individuals with a new episode of opioid, alcohol, or other drug use disorders. Treatment initiation and engagement rates, and rates of using out-of-network providers for these services, were compared between rural and urban patients. DATA COLLECTION We included individuals 18-64 years old with continuous employer-sponsored insurance. PRINCIPAL FINDINGS Patients in rural settings experienced lower treatment initiation rates for alcohol (36.6% vs. 38.0%, p < 0.001), opioid (41.2% vs. 44.2%, p < 0.001), and other drug (37.7% vs. 40.1%, p < 0.001) use disorders, relative to those in urban areas. Similarly, rural patients had lower treatment engagement rates for alcohol (15.1% vs. 17.3%, p < 0.001), opioid (21.0% vs. 22.6%, p < 0.001), and other drug (15.5% vs. 17.5%, p < 0.001) use disorders. Rural patients had higher out-of-network rates for treatment initiation for other drug use disorders (20.4% vs. 17.2%, p < 0.001), and for treatment engagement for alcohol (27.6% vs. 25.2%, p = 0.006) and other drug (36.1% vs. 31.1%, p < 0.001) use disorders. CONCLUSIONS These findings indicate that individuals with substance use disorders in rural areas have lower rates of initial and ongoing treatment, and are more likely to seek care out-of-network.
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Affiliation(s)
- Eli Raver
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Sheldon M Retchin
- Division of General Internal Medicine, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Yiting Li
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Andrew D Carlo
- Meadows Mental Health Policy Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Wendy Y Xu
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio, USA
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Honkaniemi H, Juárez SP. Alcohol-related morbidity and mortality by fathers' parental leave: A quasi-experimental study in Sweden. Addiction 2024; 119:301-310. [PMID: 37798819 DOI: 10.1111/add.16354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/30/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND AND AIMS Fathers' parental leave has been associated with decreased risks of alcohol-related hospitalizations and mortality. Whether this is attributable to the health protections of parental leave itself (through stress reduction or behavioral changes) or to selection into leave uptake remains unclear, given that fathers are more likely to use leave if they are in better health. Using the quasi-experimental variation of a reform incentivizing fathers' leave uptake (the 1995 Father's quota reform), this study aimed to assess whether fathers' parental leave influences alcohol-related morbidity and mortality. DESIGN Quasi-experimental interrupted time series and instrumental variable analyses. SETTING Sweden. PARTICIPANTS Fathers of singleton children born from January 1992 to December 1997 (n = 220 412). MEASUREMENTS Exposure was indicated by the child's birthdate before or after the reform and used to instrument fathers' 2- and 8-year parental leave uptake. Outcomes included fathers' hospitalization rates for acute alcohol-related (intoxication; mental and behavioral disorders) and chronic alcohol-related diagnoses (cardiovascular, stomach and other diseases; liver diseases), as well as alcohol-related mortality, up to 2, 8 and 18 years after the first child's birthdate. FINDINGS In interrupted time series analyses, fathers of children born after the reform exhibited immediate decreases in alcohol-related hospitalization rates up to 2 (incidence rate ratio [IRR] = 0.66, 95% confidence interval [CI] = 0.51-0.87), 8 (IRR = 0.74, 95% CI = 0.57-0.96) and 18 years after birth (IRR = 0.72, 95% CI = 0.54-0.96), particularly in acute alcohol-related hospitalization rates, compared with those with children born before. No changes were found for alcohol-related mortality. Instrumental variable results suggest that alcohol-related hospitalization decreases were driven by fathers' parental leave uptake (e.g. 2-year hospitalizations: IRR = 0.16, 95% CI = 0.03-0.84). CONCLUSIONS In Sweden, a father's parental leave eligibility and uptake may protect against alcohol-related morbidity.
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Affiliation(s)
- Helena Honkaniemi
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Sol Pía Juárez
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
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Scalzo SJ, Bowden SC. Over a Century of Study and Still Misunderstood: Recognizing the Spectrum of Acute and Chronic Wernicke-Korsakoff Syndrome. J Clin Med 2023; 12:6880. [PMID: 37959345 PMCID: PMC10649065 DOI: 10.3390/jcm12216880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
The aim of this study was to objectively evaluate the hypothesis that the neuropsychological presentation of Korsakoff's syndrome, the chronic phase of Wernicke-Korsakoff syndrome (WKS), is invariably a severe, selective amnesia against a background of relatively preserved general intellectual functions in a consecutive clinical sample. An analysis of the neuropsychological profiles of nine cases with a recorded history of WKS was undertaken. All cases were adult males (ages 32 to 70) with a long history of alcohol use disorder. Eight cases were chosen retrospectively on a consecutive basis from patient referrals. One additional case was recruited prospectively. Conventional understanding and some current opinion of Korsakoff's syndrome predicts anterograde memory to be consistently more impaired than other cognitive abilities, but this was not found in this case series. The Mean Wechsler Delayed Memory Index was not significantly different from the Wechsler Full-Scale IQ (FSIQ), p = 0.130. Regression of Delayed Memory on FSIQ produced a non-significant intercept, p = 0.213. The 'hallmark' criterion of anterograde memory score at least 20 points less than intelligence score was observed in four of eight cases with available data, equating to a 'sensitivity' of 50%. Three of eight cases with available data had an FSIQ less than the memory score. Contrary to a common view, general intellectual function was not consistently preserved in Korsakoff's syndrome relative to memory function. This study illustrates one of the specific merits of case series, namely, to critique an established view. Clinicians and researchers should expand their diagnostic criteria for Korsakoff's syndrome to include more variable cognitive phenotypes, including a potentially reversible dementia-like impairment of variable severity, and focus on potential treatment opportunities.
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Affiliation(s)
- Simon J. Scalzo
- Melbourne School of Psychological Sciences, Redmond Barry Building, University of Melbourne, Parkville, VIC 3010, Australia;
| | - Stephen C. Bowden
- Melbourne School of Psychological Sciences, Redmond Barry Building, University of Melbourne, Parkville, VIC 3010, Australia;
- Centre for Clinical Neuroscience & Neurological Research, St Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia
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Cohen SM, DePhilippis D, Deng Y, Dziura J, Ferguson T, Fucito LM, Justice AC, Maisto S, Marconi VC, Molina P, Paris M, Rodriguez-Barradas MC, Simberkoff M, Petry NM, Fiellin DA, Edelman EJ. Perspectives on contingency management for alcohol use and alcohol-associated conditions among people in care with HIV. Alcohol Clin Exp Res (Hoboken) 2023; 47:1783-1797. [PMID: 37524371 PMCID: PMC10828101 DOI: 10.1111/acer.15159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Contingency management (CM) is an evidence-based approach for reducing alcohol use; however, its implementation into routine HIV primary care-based settings has been limited. We evaluated perspectives on implementing CM to address unhealthy alcohol use and associated conditions for people with HIV in primary care settings. METHODS From May 2021 to August 2021, we conducted two focus groups with staff involved in delivering the intervention (n = 5 Social Workers and n = 4 Research Coordinators) and individual interviews (n = 13) with a subset of participants involved in the multi-site Financial Incentives, Randomization, and Stepped Treatment (FIRST) trial. Qualitative data collection and analyses were informed by the Promoting Action on Research Implementation in Health Service (PARIHS) implementation science framework, including evidence (perception of CM), context (HIV primary care clinic and CM procedures), and facilitation (feasibility outside the research setting). RESULTS Several major themes were identified. Regarding the evidence, participants lacked prior experience with CM, but the intervention was well received and, by some, perceived to lead to lasting behavior change. Regarding the clinical context for the reward schedule, the use of biochemical testing, specifically fingerstick phosphatidylethanol testing, and the reward process were perceived to be engaging and gratifying for both staff and patients. Participants indicated that the intervention was enhanced by its co-location within the HIV clinic. Regarding facilitation, participants suggested addressing the intervention's feasibility for non-research use, simplifying the reward structure, and rewarding non-abstinence in alcohol use. CONCLUSIONS Among patients and staff involved in a clinical trial, CM was viewed as a helpful, positive, and feasible approach to addressing unhealthy alcohol use and related conditions. To enhance implementation, future efforts may consider simplified approaches to the reward structure and expanding rewards to non-abstinent reductions in alcohol consumption.
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Affiliation(s)
- Shawn M. Cohen
- Program in Addiction Medicine, Yale School of Medicine, 367 Cedar Street, Suite 417A, New Haven, CT 06510, USA
- Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, P.O. Box 208056, New Haven, CT 06510, USA
| | - Dominick DePhilippis
- Veterans Affairs Office of Mental Health and Suicide Prevention, US Department of Veterans Affairs, Washington, D.C. 20420, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Yanhong Deng
- Yale Center for Analytic Sciences, Yale School of Public Health, New Haven, CT 06511, USA
| | - James Dziura
- Yale Center for Analytic Sciences, Yale School of Public Health, New Haven, CT 06511, USA
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT
| | - Tekeda Ferguson
- Department of Epidemiology, Louisiana State University School of Public Health, New Orleans, LA
| | - Lisa M. Fucito
- Department of Psychiatry, Yale School of Medicine
- Yale Cancer Center, New Haven, CT 06510, USA
| | - Amy C. Justice
- Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, P.O. Box 208056, New Haven, CT 06510, USA
- Yale School of Public Health, New Haven, CT 06510, USA
- Veterans Affairs Connecticut Healthcare System, Veterans Aging Cohort Study, West Haven, CT 06516, USA
| | | | - Vincent C. Marconi
- Atlanta Veterans Affairs Medical Center, Emory University School of Medicine and Rollins School of Public Health, Atlanta, GA 30033, USA
| | - Patricia Molina
- Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
- Department of Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Manuel Paris
- Department of Psychiatry, Yale School of Medicine
| | | | - Michael Simberkoff
- Veterans Affairs NY Harbor Healthcare System and New York University School of Medicine, New York, NY 10010, USA
| | - Nancy M. Petry
- Pat and Jim Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, CT
| | - David A. Fiellin
- Program in Addiction Medicine, Yale School of Medicine, 367 Cedar Street, Suite 417A, New Haven, CT 06510, USA
- Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, P.O. Box 208056, New Haven, CT 06510, USA
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 135 College Street, Suite 200, New Haven, CT 06510, USA
| | - E. Jennifer Edelman
- Program in Addiction Medicine, Yale School of Medicine, 367 Cedar Street, Suite 417A, New Haven, CT 06510, USA
- Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, P.O. Box 208056, New Haven, CT 06510, USA
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 135 College Street, Suite 200, New Haven, CT 06510, USA
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Hobden B, Freund M, Lawson S, Bryant J, Walsh J, Leigh L, Sanson‐Fisher R. The impact of organisational factors on treatment outcomes for those seeking alcohol or other drug treatment: A systematic review. Drug Alcohol Rev 2023; 42:1220-1234. [PMID: 37005012 PMCID: PMC10947488 DOI: 10.1111/dar.13653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 02/24/2023] [Accepted: 03/16/2023] [Indexed: 04/04/2023]
Abstract
INTRODUCTION Organisational factors have been found to be associated with health outcomes in a number of health-care settings. Despite likely being an important influence on the quality of care provided within alcohol and other drug (AOD) treatment centres, the impact of organisational factors on AOD treatment outcomes have not been extensively explored. This systematic literature review examines the characteristics, methodological quality and findings of published studies exploring the association between organisational factors and client AOD treatment outcomes. METHODS Medline, Embase, PsycINFO and the Cochrane database were searched from 2010 to March 2022 for relevant papers. Studies meeting the inclusion criteria underwent quality assessment using the Joanna Brigg's Institute critical appraisal tool for cross-sectional studies, followed by data extraction of key variables pertaining to the aims. A narrative summary was used to synthesise the data. RESULTS Nine studies met the inclusion criteria. Organisational factors examined included cultural competency, organisational readiness for change, directorial leadership, continuity of care practices, service access, service to needs ratios, dual diagnosis training, therapeutic optimism and the funding model/health-care system that treatment was delivered in. Outcome measures included duration, completion or continuation of treatment; AOD use; and patient perceptions of treatment outcomes. Seven out of nine papers found a significant interaction between at least one organisational variable and AOD treatment outcomes. DISCUSSION AND CONCLUSIONS Organisational factors are likely to impact treatment outcomes for patients seeking treatment for AOD. Further examination of the organisational factors that influence AOD outcomes is needed to inform systemic improvements to AOD treatment.
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Affiliation(s)
- Breanne Hobden
- Health Behaviour Research CollaborativeSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of NewcastleNewcastleAustralia
- Equity in Health and Wellbeing Program, Hunter Medical Research InstituteNewcastleAustralia
| | - Megan Freund
- Health Behaviour Research CollaborativeSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of NewcastleNewcastleAustralia
- Equity in Health and Wellbeing Program, Hunter Medical Research InstituteNewcastleAustralia
| | - Samuel Lawson
- Health Behaviour Research CollaborativeSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of NewcastleNewcastleAustralia
- Equity in Health and Wellbeing Program, Hunter Medical Research InstituteNewcastleAustralia
| | - Jamie Bryant
- Health Behaviour Research CollaborativeSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of NewcastleNewcastleAustralia
- Equity in Health and Wellbeing Program, Hunter Medical Research InstituteNewcastleAustralia
| | - Justin Walsh
- Health Behaviour Research CollaborativeSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of NewcastleNewcastleAustralia
- Equity in Health and Wellbeing Program, Hunter Medical Research InstituteNewcastleAustralia
| | - Lucy Leigh
- Clinical Research Design and StatisticsHunter Medical Research InstituteNewcastleAustralia
| | - Rob Sanson‐Fisher
- Health Behaviour Research CollaborativeSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of NewcastleNewcastleAustralia
- Equity in Health and Wellbeing Program, Hunter Medical Research InstituteNewcastleAustralia
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Schuch JB, Becker N, Rabelo-da-Ponte FD, Ornell F, Freitas HJM, Rebelatto FP, Sordi AO, Pechansky F, von Diemen L, Kessler FHP. Assessment of cognitive functioning using the Mini Mental State Examination in men with Alcohol and Crack Cocaine Use Disorder. Trends Psychiatry Psychother 2023; 45:e20220567. [PMID: 36889679 PMCID: PMC10597386 DOI: 10.47626/2237-6089-2022-0567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 03/01/2023] [Indexed: 03/10/2023]
Abstract
INTRODUCTION Consumption of substances has been associated with cognitive impairment. The Mini Mental State Examination (MMSE) is an easy-to-apply screening tool used to assess cognitive functions. OBJECTIVES To evaluate the cognitive performance of individuals with alcohol (AUD) and/or crack cocaine use disorder (CUD) and polysubstance use using the MMSE and to investigate the impact of substance use profile and the moderation effect of educational level on MMSE performance. METHODS Cross-sectional study with 508 adult male inpatients diagnosed with substance use disorders (245 with AUD, 85 with CUD, and 178 with polysubstance use). Cognitive performance was assessed using the MMSE scale (total and composite scores). RESULTS Individuals with AUD had worse total MMSE scores and scored worse for all three MMSE components compared to individuals with polysubstance use (p < 0.001, oral/written language comprehension, p < 0.001, attention/memory, and p = 0.007, motor functions). MMSE scores were positively correlated with educational level (p < 0.017), but were not associated with age, recent drug use, or years of drug use. Educational level moderated the impact of substance use on MMSE performance, especially total score and composite language comprehension score. Individuals with a low educational level (≤ 8 years) had worse performance than those with a high educational level (≥ 9 years), mainly in individuals with AUD (p < 0.001). DISCUSSION Individuals with a low educational level and alcohol use are more prone to present cognitive impairment than crack cocaine users, especially involving language aspects. Better-preserved cognitive function could impact treatment adherence and might guide the decision of therapeutic strategies.
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Affiliation(s)
- Jaqueline B Schuch
- Centro de Pesquisa em Álcool e Drogas, Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Natália Becker
- Centro de Pesquisa em Álcool e Drogas, Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Programa de Pós-Graduação em Distúrbios do Desenvolvimento, Universidade Presbiteriana Mackenzie, São Paulo, SP, Brazil
| | - Francisco Diego Rabelo-da-Ponte
- Centro de Pesquisa em Álcool e Drogas, Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil. Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Felipe Ornell
- Centro de Pesquisa em Álcool e Drogas, Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Hellen J M Freitas
- Centro de Pesquisa em Álcool e Drogas, Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Fernando P Rebelatto
- Centro de Pesquisa em Álcool e Drogas, Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Anne O Sordi
- Centro de Pesquisa em Álcool e Drogas, Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Flavio Pechansky
- Centro de Pesquisa em Álcool e Drogas, Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Lisia von Diemen
- Centro de Pesquisa em Álcool e Drogas, Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
| | - Felix H P Kessler
- Centro de Pesquisa em Álcool e Drogas, Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil
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Smith BT, Schoer N, Sherk A, Thielman J, McKnight A, Hobin E. Trends in alcohol-attributable hospitalisations and emergency department visits by age, sex, drinking group and health condition in Ontario, Canada. Drug Alcohol Rev 2023; 42:926-937. [PMID: 36843065 DOI: 10.1111/dar.13629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/20/2022] [Accepted: 01/26/2023] [Indexed: 02/28/2023]
Abstract
INTRODUCTION Alcohol-attributable harms are increasing in Canada. We described trends in alcohol-attributable hospitalisations and emergency department (ED) visits by age, sex, drinking group, attribution and health condition. METHODS Hospitalisation and ED visits for partially or wholly alcohol-attributable health conditions by age and sex were obtained from population-based health administrative data for individuals aged 15+ in Ontario, Canada. Population-level alcohol exposure was estimated using per capita alcohol sales and alcohol use data. We estimated the number and rate of alcohol-attributable hospitalisations (2008-2018) and ED visits (2008-2019) using the International Model of Alcohol Harms and Policies (InterMAHP). RESULTS Over the study period, the modelled rates of alcohol-attributable health-care encounters were higher in males, but increased faster in females. Specifically, rates of alcohol-attributable hospitalisations and ED visits increased by 300% (19-76 per 100,000) and 37% (774-1,064 per 100,000) in females, compared to 20% (322-386 per 100,000) and 2% (2563-2626 per 100,000) in males, respectively. Alcohol-attributable ED visit rates were highest among individuals aged 15-34, however, increased faster among individuals aged 65+ (females: 266%; males: 44%) than 15-34 years (females:+17%; males: -16%). High-volume drinkers had the highest rates of alcohol-attributable health-care encounters; yet, low-/medium-volume drinkers contributed substantial hospitalisations (11%) and ED visits (36%), with increasing rates of ED visits in females drinking low/medium volumes. DISCUSSION AND CONCLUSIONS Alcohol-attributable health-care encounters increased overall, and faster among females, adults aged 65+ and low-/medium-volume drinkers. Monitoring trends across subpopulations is imperative to inform equitable interventions to mitigate alcohol-attributable harms.
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Affiliation(s)
- Brendan T Smith
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Nicole Schoer
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
| | - Adam Sherk
- Canadian Institute for Substance Use Research, University of Victoria, Technology Enterprise Facility, Victoria, Canada
| | - Justin Thielman
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
| | - Anthony McKnight
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Erin Hobin
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Canadian Institute for Substance Use Research, University of Victoria, Technology Enterprise Facility, Victoria, Canada
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de Vargas D, Marques DA, Volpato RJ, Ramirez EGL, Nobrega MDPSDS. Internal validity evidence of a knowledge questionnaire on alcohol use, abuse and dependence and associated questions. Rev Bras Enferm 2023; 76:e20210377. [PMID: 36753191 PMCID: PMC9901347 DOI: 10.1590/0034-7167-2021-0377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/21/2022] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES to perform content validity and verify the psychometric properties of the adapted version of an alcohol knowledge questionnaire and associated questions. METHODS a methodological study, in which a committee of judges analyzed the questionnaire item representativeness, clarity and relevance. Item response theory was used to assess the instrument psychometric properties applied to a sample of 240 health professionals. RESULTS the questions were adjusted according to judges' assessment, obtaining a satisfactory Content Validity Index (0.98). High discrimination ability and adequate difficulty levels were observed in 75% of multiple-choice questions and in 25% of statements. CONCLUSIONS the instrument presented content validity with satisfactory indices. However, it is recommended that the questionnaire adapted in this study be used in different samples of health professionals from other parts of Brazil, in order to provide greater robustness to its reliability.
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10
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Yoshioka T, So R, Takayama A, Okubo R, Funada S, Takada M, Wakabayashi M, Tabuchi T. Strong chū-hai, a Japanese ready-to-drink high-alcohol-content beverage, and hazardous alcohol use: A nationwide cross-sectional study. Alcohol Clin Exp Res 2023; 47:285-295. [PMID: 36478596 DOI: 10.1111/acer.14991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/23/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND A new ready-to-drink premixed high-alcohol-content beverage, called strong chū-hai, was launched in Japan, and more recently, in Taiwan and Australia. We aimed to examine the popularity and association of strong chū-hai with individual alcohol use, both of which remained unclear. METHODS We conducted a cross-sectional study using data from the Japan "Society and New Tobacco" Internet Survey conducted from February 1 to 28, 2022, in Japan. We enrolled 27,993 respondents (aged 15 to 81 years; male 48.5%), including 15,083 current alcohol users. Using inverse probability weighting of data from the 2016 Comprehensive Survey of Living Conditions on Health and Welfare, we estimated the weighted proportions of strong chū-hai users among all respondents and constructed multivariable logistic regression models to estimate the weighted odds ratios (OR) and 95% confidence intervals (CI) of strong chū-hai use for hazardous and harmful alcohol use, defined as a score ≥8 of the Alcohol Use Disorder Identification Test, among current alcohol users. RESULTS Among all respondents, 56.2% (weighted proportions: past, 35.9%; and current, 20.3%) drank strong chū-hai. Among drinkers, both past and current strong chū-hai use, compared to never use, were associated with hazardous and harmful alcohol use (past, OR 1.73, 95% CI 1.42 to 2.12; current, OR 2.19, 95% CI 1.79 to 2.69). CONCLUSIONS Our study found that more than half of the respondents experienced strong chū-hai consumption, suggesting that it is widely used in Japan. In addition, both past and current strong chū-hai use were associated with hazardous and harmful alcohol use among current alcohol users.
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Affiliation(s)
- Takashi Yoshioka
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
| | - Ryuhei So
- Department of Psychiatry, Okayama Psychiatric Medical Center, Okayama, Japan
| | - Atsushi Takayama
- Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan
| | - Ryo Okubo
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Satoshi Funada
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan.,Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Midori Takada
- Department of Cardiovascular Disease Prevention, Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Mami Wakabayashi
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan.,The Tokyo Foundation for Policy Research, Tokyo, Japan
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11
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Lichtwarck HO, Kazaura MR, Moen K, Mmbaga EJ. Harmful Alcohol Use and Associated Socio-Structural Factors among Female Sex Workers Initiating HIV Pre-Exposure Prophylaxis in Dar es Salaam, Tanzania. Int J Environ Res Public Health 2022; 20:698. [PMID: 36613018 PMCID: PMC9819768 DOI: 10.3390/ijerph20010698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/21/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
Harmful alcohol use is an important risk factor for premature mortality and morbidity and associated with increased HIV risk and lower uptake of and adherence to HIV interventions. This study aimed to assess the extent of harmful alcohol use and associated socio-structural vulnerability factors among female sex workers in Dar es Salaam, Tanzania, a key population in the HIV epidemic. Data from a study of female sex workers initiating pre-exposure prophylaxis (PrEP) recruited through respondent driven sampling were used. We assessed harmful alcohol use with the Alcohol Use Disorders Identification Test (AUDIT) defined as having an AUDIT score ≥ 16. Associations between harmful alcohol use and socio-structural factors were assessed using logistic regression with marginal standardization. Of the 470 women recruited, more than one third (37.3%) had a drinking pattern suggestive of harmful alcohol use. Such use was independently associated with sex work-related mobility (aPR: 1.36, 95% CI: 1.11-1.61), arrest/incarceration (aPR: 1.55, 95% CI: 1.27-1.84) and gender-based violence (aPR: 1.31, 95% CI: 1.06-1.56). The high prevalence of harmful alcohol use and the interconnectedness with socio-structural factors indicate a need for a holistic programmatic approach to health for female sex workers. Programming should not solely direct attention to individual behavior but also include strategies aiming to address socio-structural vulnerabilities.
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Affiliation(s)
- Hanne Ochieng Lichtwarck
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, 0450 Oslo, Norway
| | - Method Rwelengera Kazaura
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam 11103, Tanzania
| | - Kåre Moen
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, 0450 Oslo, Norway
| | - Elia John Mmbaga
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, 0450 Oslo, Norway
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam 11103, Tanzania
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12
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Tew JC, Harrington L, Elsayed H, Mlawa G. Pellagra as a differential diagnosis in the confused patient on the acute medical unit. BMJ Case Rep 2022; 15:e249405. [PMID: 36323450 PMCID: PMC9639017 DOI: 10.1136/bcr-2022-249405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A man in his 80s was admitted via the acute medical take after presenting with increased confusion and features of alcohol withdrawal. He had a several-month history of a worsening pruritic rash surrounding his neck, arms and legs in addition to new, profuse diarrhoea. In view of the background of known chronic alcoholism and the coexisting symptoms of rash, confusion and diarrhoea, pellagra was diagnosed via a multidisciplinary approach. Oral nicotinamide supplementation was commenced and his symptoms responded rapidly. The bias and challenge of reaching a unified diagnosis in the context of a multisystem condition are exemplified in this case report.
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Affiliation(s)
- Jennifer Catherine Tew
- Acute Medicine, Barking Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - Laura Harrington
- General Internal Medicine, Barking Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - Haythum Elsayed
- General Internal Medicine, Barking Havering and Redbridge University Hospitals NHS Trust, Romford, UK
| | - Gideon Mlawa
- Diabetes and Endocrinology/General Internal Medicine, Queen's Hospital Romford, London, UK
- Diabetes and Endocrinology/General Internal Medicine, Barking Havering and Redbridge University Hospitals NHS Trust, Romford, UK
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13
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Barbosa JDSP, Pereira LC, Salgado FXC, da Silva RM, Karnikowski MGDO. An Assessment of Mortality among Elderly Brazilians from Alcohol Abuse Diseases: A Longitudinal Study from 1996 to 2019. Int J Environ Res Public Health 2022; 19:13467. [PMID: 36294044 PMCID: PMC9603807 DOI: 10.3390/ijerph192013467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Alcohol use disorder (AUD) is a worldwide public health problem, being an important aggravating factor of comorbidities found in the elderly, with the potential to increase mortality indicators for this age group. OBJECTIVE To analyze alcohol-induced deaths in elderly people with alcohol-related disorder in Brazil between 1996 and 2019. METHODS An ecological study was conducted with secondary data obtained from the Brazilian Unified Health System (SIM) Mortality Information System from 1996 to 2019. TabNet/DATASUS, Excel® 2016 and SPSS 21® were used to prepare the results. RESULTS Between 1996 and 2019, 85,928 alcohol-induced deaths were recorded among the elderly (>60 years); in 1996, the lowest number of deaths was recorded (n = 1396), and in 2018, there were the highest number of deaths (n = 5667). In the profile of the elderly, there was a predominance of men (88%). Mortality from AUD was due to alcoholic liver disease (62.2%), followed by mental disorders due to alcohol use (37.3%). CONCLUSIONS Coping with AUD is a public health problem that aims to reduce the number of deaths from diseases, conditions and injuries in which alcohol consumption is the causative agent, in addition to preventing deaths to which alcohol contributes.
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Affiliation(s)
- João de Sousa Pinheiro Barbosa
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilândia, University of Brasilia, Metropolitan Center, Brasilia 72220-275, Brazil
- Faculty of Education and Health Sciences—FACES—Medicine Course, University Center of Brasília—UniCEUB, 707/907, Asa Norte, Brasilia 70790-075, Brazil
| | - Leonardo Costa Pereira
- Faculty of Health, Euroamerican University Center—UniEURO, Avenida das Nações, Trecho 0, Conjunto 05, Asa Sul, Brasilia 70200-001, Brazil
| | - Fabiana Xavier Cartaxo Salgado
- Faculty of Education and Health Sciences—FACES—Medicine Course, University Center of Brasília—UniCEUB, 707/907, Asa Norte, Brasilia 70790-075, Brazil
| | - Rodrigo Marques da Silva
- Faculty of Education and Health Sciences—FACES—Medicine Course, University Center of Brasília—UniCEUB, 707/907, Asa Norte, Brasilia 70790-075, Brazil
| | - Margô Gomes de Oliveira Karnikowski
- Graduate Program in Health Sciences and Technologies, Faculty of Ceilândia, University of Brasilia, Metropolitan Center, Brasilia 72220-275, Brazil
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14
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Hou C, Zeng Y, Chen W, Han X, Yang H, Ying Z, Hu Y, Sun Y, Qu Y, Fang F, Song H. Medical conditions associated with coffee consumption: Disease-trajectory and comorbidity network analyses of a prospective cohort study in UK Biobank. Am J Clin Nutr 2022; 116:730-740. [PMID: 35849013 PMCID: PMC9437992 DOI: 10.1093/ajcn/nqac148] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/14/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Habitual coffee consumption has been associated with multiple health benefits. A comprehensive analysis of disease trajectory and comorbidity networks in relation to coffee consumption is, however, currently lacking. OBJECTIVES We aimed to comprehensively examine the health outcomes associated with habitual coffee consumption, through clarifying its disease trajectory and comorbidity networks. METHODS Based on the UK Biobank cohort, we included 395,539 individuals with available information on coffee intake collected at recruitment between 2006 and 2010. These individuals were categorized as having low (<1 cup per day), moderate (1-3 cups), and high (≥4 cups) levels of coffee intake, and were followed through 2020 to ascertain 496 medical conditions. Cox regression was used to assess the associations between high-level coffee intake and the risk of medical conditions with a prevalence ≥0.5% in the study population, after adjusting for multiple confounders, using low-level coffee intake as the reference. Disease-trajectory and comorbidity network analyses were then applied to visualize the temporal and nontemporal relationships between the medical conditions that had an inverse association with high-level coffee intake. RESULTS During a median follow-up of 11.8 years, 31 medical conditions were found to be associated with high-level coffee intake, among which 30 showed an inverse association (HRs ranged from 0.61 to 0.94). The inverse associations were more pronounced for women, compared with men. Disease-trajectory and comorbidity network analyses of these 30 conditions identified 4 major clusters of medical conditions, mainly in the cardiometabolic and gastrointestinal systems, among both men and women; 1 cluster of medical conditions following alcohol-related disorders, primarily among men; as well as a cluster of estrogen-related conditions among women. CONCLUSIONS Habitual coffee consumption was associated with lower risks of many medical conditions, especially those in the cardiometabolic and gastrointestinal systems and those related to alcohol use and estrogen regulation.
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Affiliation(s)
- Can Hou
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.,Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yu Zeng
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.,Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Wenwen Chen
- Division of Nephrology, Kidney Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Han
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.,Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Huazhen Yang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.,Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Zhiye Ying
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.,Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yao Hu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.,Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yajing Sun
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.,Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yuanyuan Qu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.,Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Huan Song
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.,Med-X Center for Informatics, Sichuan University, Chengdu, China.,Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
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15
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O’Donovan G, Hamer M. Risk Factors for Problematic Drinking in One's Thirties and Forties: A Longitudinal Analysis of the 1970 British Cohort Study. Int J Environ Res Public Health 2022; 19:10664. [PMID: 36078379 PMCID: PMC9518189 DOI: 10.3390/ijerph191710664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
Alcohol drinking and risk factors for problematic drinking may vary across a lifespan. The objective of this study was to identify risk factors for problematic drinking in men and women in their thirties and forties. Alcohol drinking and potential risk factors for problematic drinking were assessed at ages 30, 34, 42, and 46 in the 1970 British Cohort Study. Multilevel models included 10,079 observations in 3880 men and 9241 observations in 3716 women. In men, formerly smoking, currently smoking, having a degree, having malaise, and having a mother who drank while pregnant were independently associated with increased risk of problematic drinking. In women, formerly smoking, currently smoking, being physically active in one's leisure time, having a degree, having a managerial or professional occupation, having malaise, and having a mother who drank while pregnant were independently associated with increased risk of problematic drinking. In men and women, cohabiting as a couple was associated with decreased risk of problematic drinking. This study suggests that several risk factors may be associated with problematic drinking in men and women in their thirties and forties. Policy makers should consider the role of modifiable risk factors in the prevention of problematic drinking.
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Affiliation(s)
- Gary O’Donovan
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Peñalolén, Santiago 7941169, Chile
- Facultad de Medicina, Universidad de los Andes, Carrera 1, 18A-12, Bogotá 111711, Colombia
| | - Mark Hamer
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, Institute Sport Exercise Health, University College London, 170 Tottenham Court Road, London WC1E 6BT, UK
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16
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Paolillo EW, Saloner R, Kohli M, Watson CW, Moore RC, Heaton RK, Moore DJ. Binge Drinking Relates to Worse Neurocognitive Functioning Among Adults Aging with HIV. J Int Neuropsychol Soc 2022; 28:600-10. [PMID: 34308804 DOI: 10.1017/S1355617721000783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Given the aging population of people with HIV (PWH), along with increasing rates of binge drinking among both PWH and the general older adult population, this study examined the independent and interactive effects of HIV, binge drinking, and age on neurocognition. METHOD Participants were 146 drinkers stratified by HIV and binge drinking status (i.e., ≥4 drinks for women and ≥5 drinks for men within approximately 2 h): HIV+/Binge+ (n = 30), HIV-/Binge+ (n = 23), HIV+/Binge- (n = 55), HIV-/Binge- (n = 38). All participants completed a comprehensive neuropsychological battery measuring demographically-corrected global and domain-specific neurocognitive T scores. ANCOVA models examined independent and interactive effects of HIV and binge drinking on neurocognitive outcomes, adjusting for overall alcohol consumption, lifetime substance use, sex, and age. Subsequent multiple linear regressions examined whether HIV/Binge group moderated the relationship between age and neurocognition. RESULTS HIV+/Binge+ participants had worse global neurocognition, processing speed, delayed recall, and working memory than HIV-/Binge- participants (p's < .05). While there were significant main effects of HIV and binge drinking, their interaction did not predict any of those neurocognitive outcomes (p's > .05). Significant interactions between age and HIV/Binge group showed that HIV+/Binge+ participants demonstrated steeper negative relationships between age and neurocognitive outcomes of learning, delayed recall, and motor skills compared to HIV-/Binge- participants (p's < .05). CONCLUSIONS Results showed adverse additive effects of HIV and binge drinking on neurocognitive functioning, with older adults demonstrating the most vulnerability to these effects. Findings support the need for interventions to reduce binge drinking, especially among older PWH.
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17
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Keyes D, Talarico P, Hardin B, Molter A, Lee H, Valiuddin H, Moore B. Suicidal ideation and sobriety: Should acute alcohol intoxication be taken into account for psychiatric evaluation? Alcohol Clin Exp Res 2022; 46:1306-1312. [PMID: 35581530 DOI: 10.1111/acer.14871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 05/09/2022] [Accepted: 05/09/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND When evaluating an emergency department (ED) patient who presents with suicidal ideation, it is a common practice to wait until the patient's ethanol level is known or calculated to be less than 80 mg/dl to evaluate patient safety. We know of no study that establishes an association between the degree of alcohol intoxication based on a blood alcohol level (BAL) and reported suicidal ideation (SI) upon recovery. METHODS We conducted a retrospective review of patients evaluated in a Midwestern ED for the calendar year 2017. Cases were selected if they had a psychiatric social work consult and a blood alcohol level drawn while in the ED. Patients were selected on the same 2 days each week throughout the year to meet the sample size requirements of the study, resulting in 1084 cases for review. Chi-square analysis was used to evaluate the relationship between suicidal ideation and alcohol intoxication as defined by a BAL ≥80 mg/dl. RESULTS Among patients presenting with suicidal ideation and a concurrent BAL ≥80 mg/dl, 69% no longer reported suicidal ideation when their BAL was <80 mg/dl, compared to 38% for patients without a positive BAL on presentation (chi-square, p = 0.000012). CONCLUSION Our data show that patients presenting to the ED with complaints related to suicidal behavior who have a BAL ≥80 mg/dl are more likely to no longer endorse having suicidal ideation once their BAL is < 80 mg/dl than patients with similar presenting complaints and no alcohol intoxication. This finding supports the common ED practice of re-assessing suicidal ideation among individuals who are initially intoxicated once their BAL has decreased below 80 mg/dl.
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Affiliation(s)
- Daniel Keyes
- College of Osteopathic Medicine, Michigan State University, Lansing, Michigan, USA.,GME Research Department, Trinity Health Livonia Hospital, Livonia, Michigan, USA.,Departments of Emergency Medicine and Psychiatry, Trinity Health Livonia Hospital, Livonia, Michigan, USA.,Natural Sciences, College of Arts Sciences and Letters, University of Michigan-Dearborn, Dearborn, Michigan, USA
| | - Philip Talarico
- Meadville Medical Center, Mind Body Wellness Center, Meadville, Pennsylvania, USA
| | - Blake Hardin
- GME Research Department, Trinity Health Livonia Hospital, Livonia, Michigan, USA.,Natural Sciences, College of Arts Sciences and Letters, University of Michigan-Dearborn, Dearborn, Michigan, USA
| | - Alexander Molter
- GME Research Department, Trinity Health Livonia Hospital, Livonia, Michigan, USA
| | - Honesty Lee
- GME Research Department, Trinity Health Livonia Hospital, Livonia, Michigan, USA
| | - Hisham Valiuddin
- Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Brandon Moore
- Departments of Emergency Medicine and Psychiatry, Trinity Health Livonia Hospital, Livonia, Michigan, USA
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18
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Pinar-Sanchez J, Bermejo López P, Solís García Del Pozo J, Redondo-Ruiz J, Navarro Casado L, Andres-Pretel F, Celorrio Bustillo ML, Esparcia Moreno M, García Ruiz S, Solera Santos JJ, Navarro Bravo B. Common Laboratory Parameters Are Useful for Screening for Alcohol Use Disorder: Designing a Predictive Model Using Machine Learning. J Clin Med 2022; 11:2061. [PMID: 35407669 DOI: 10.3390/jcm11072061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/01/2022] [Accepted: 04/03/2022] [Indexed: 11/16/2022] Open
Abstract
The diagnosis of alcohol use disorder (AUD) remains a difficult challenge, and some patients may not be adequately diagnosed. This study aims to identify an optimum combination of laboratory markers to detect alcohol consumption, using data science. An analytical observational study was conducted with 337 subjects (253 men and 83 women, with a mean age of 44 years (10.61 Standard Deviation (SD)). The first group included 204 participants being treated in the Addictive Behaviors Unit (ABU) from Albacete (Spain). They met the diagnostic criteria for AUD specified in the Diagnostic and Statistical Manual of mental disorders fifth edition (DSM-5). The second group included 133 blood donors (people with no risk of AUD), recruited by cross-section. All participants were also divided in two groups according to the WHO classification for risk of alcohol consumption in Spain, that is, males drinking more than 28 standard drink units (SDUs) or women drinking more than 17 SDUs. Medical history and laboratory markers were selected from our hospital's database. A correlation between alterations in laboratory markers and the amount of alcohol consumed was established. We then created three predicted models (with logistic regression, classification tree, and Bayesian network) to detect risk of alcohol consumption by using laboratory markers as predictive features. For the execution of the selection of variables and the creation and validation of predictive models, two tools were used: the scikit-learn library for Python, and the Weka application. The logistic regression model provided a maximum AUD prediction accuracy of 85.07%. Secondly, the classification tree provided a lower accuracy of 79.4%, but easier interpretation. Finally, the Naive Bayes network had an accuracy of 87.46%. The combination of several common biochemical markers and the use of data science can enhance detection of AUD, helping to prevent future medical complications derived from AUD.
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19
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Oldfield BJ, Li Y, Vickers-Smith R, Barry DT, Crystal S, Gordon KS, Kerns RD, Williams EC, Marshall BDL, Edelman EJ. Longitudinal analysis of the prevalence and correlates of heavy episodic drinking and self-reported opioid use among a national cohort of patients with HIV. Alcohol Clin Exp Res 2022; 46:600-613. [PMID: 35257397 PMCID: PMC9018502 DOI: 10.1111/acer.14801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 02/20/2022] [Accepted: 02/25/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Heavy episodic drinking (HED) is a risk factor for opioid-related overdose and negatively impacts HIV disease progression. Among a national cohort of patients with HIV (PWH), we examined sociodemographic and clinical correlates of concomitant HED and self-reported opioid use. METHODS We used data collected from 2002 through 2018 from the Veterans Aging Cohort Study, a prospective cohort including PWH in care at eight US Veterans Health Administration sites. HED was defined as consuming six or more drinks at least once in the year prior to survey collection. We examined the relationship between HED and self-reported opioid use and created a 4-level composite variable of HED and opioid use. We used multinomial logistic regression to estimate odds of reporting concomitant HED and self-reported opioid use. RESULTS Among 3702 PWH, 1458 (39.4%) reported HED during the study period and 350 (9.5%) reported opioid use. In the multinomial model, compared to reporting neither HED nor opioid use, lifetime housing instability (adjusted odds ratio [aOR] 1.54, 95% confidence interval [CI] 1.01 to 2.35), Veterans Aging Cohort Study Index 2.0 (a measure of disease severity; aOR 1.14, 95% CI 1.02 to 1.28), depressive symptoms (aOR 2.27, 95% CI 1.42 to 3.62), past-year cigarette smoking (aOR 3.06, 95% CI 1.53 to 6.14), cannabis use (aOR 1.69, 95% CI 1.09 to 2.62), and cocaine/stimulant use (aOR 11.54, 95% CI 7.40 to 17.99) were independently associated with greater odds of concomitant HED and self-reported opioid use. Compared to having attended no college, having some college or more (aOR 0.39, 95% CI 0.26 to 0.59) was associated with lower odds of concomitant HED and self-reported opioid use. CONCLUSIONS Among PWH, concomitant HED and self-reported opioid use are more common among individuals with depressive symptoms and substance use, structural vulnerabilities, and greater illness severity. Efforts to minimize opioid-related risk should address high-risk drinking as a modifiable risk factor for harm among these groups.
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Affiliation(s)
- Benjamin J Oldfield
- Fair Haven Community Health Care, New Haven, Connecticut, USA.,Yale School of Medicine, New Haven, Connecticut, USA
| | - Yu Li
- Brown University School of Public Health, Providence, Rhode Island, USA
| | - Rachel Vickers-Smith
- Department of Epidemiology, University of Kentucky College of Public Health, Lexington, Kentucky, USA
| | | | - Stephen Crystal
- Center for Health Services Research, Institute for Health, Rutgers University, Rutgers, New Jersey, USA
| | - Kirsha S Gordon
- Yale School of Medicine, New Haven, Connecticut, USA.,VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Robert D Kerns
- Yale School of Medicine, New Haven, Connecticut, USA.,VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Emily C Williams
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Washington, USA.,Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, VA Health Services Research and Development, VA Puget Sound, Seattle, Washington, USA
| | | | - E Jennifer Edelman
- Yale School of Medicine, New Haven, Connecticut, USA.,Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, Connecticut, USA
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20
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Perino J, Tournier M, Mathieu C, Letinier L, Peyré A, Perret G, Pereira E, Fourrier-Réglat A, Pollet C, Fatseas M, Tzourio C, Daveluy A. Psychoactive substance use among students: A cross-sectional analysis. Fundam Clin Pharmacol 2022; 36:908-914. [PMID: 35194825 PMCID: PMC9544725 DOI: 10.1111/fcp.12771] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 01/17/2022] [Accepted: 02/21/2022] [Indexed: 01/10/2023]
Abstract
Little is known about psychoactive substance use in students, apart from tobacco, alcohol, and cannabis. This study investigated the prevalence of substance use and overlap between various psychoactive substances in students. This cross‐sectional study was conducted in 10 066 students included in the i‐Share cohort between January 1, 2015, and December 31, 2017. The baseline questionnaire was the key source of information. Psychoactive substances of interest (PSI) were cannabis, cocaine, amphetamines, nitrous oxide, poppers, and MDMA. Their patterns of use were categorized as lifetime, past year, and current use. The use of other psychoactive substances including alcohol and tobacco was described in PSI users and non‐users. Most participants were female (75%), and their average age was 21 years. Lifetime use of at least one PSI was reported by 65.5% of participants. Cannabis was the most frequently used substance both over lifetime (57% of students) and past year (35%), followed by poppers and nitrous oxide (28% and 26% of students over lifetime, respectively). Among polydrug users (n = 1242), 65% used only nitrous oxide and poppers, showing a strong link between these two substances. Regular alcohol use, binge drinking, and current tobacco use were higher in PSI users than in non‐users. Substance use was higher than previously found in both French and European studies in young people. Nitrous oxide use was particularly high. Regular alcohol use, binge drinking, and tobacco use could be used as markers to identify students at risk of PSI use to be targeted by prevention programs.
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Affiliation(s)
- Justine Perino
- Department of Medical Pharmacology, Centre d'addictovigilance de Bordeaux, Bordeaux, France.,Univ. Bordeaux, INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.,CHU de Bordeaux, Bordeaux, France
| | - Marie Tournier
- Univ. Bordeaux, INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.,Hospital Charles Perrens, Bordeaux, France
| | - Clément Mathieu
- Univ. Bordeaux, INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France
| | - Louis Letinier
- Univ. Bordeaux, INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.,CHU de Bordeaux, Bordeaux, France
| | - Alexandre Peyré
- Department of Medical Pharmacology, Centre d'addictovigilance de Bordeaux, Bordeaux, France.,CHU de Bordeaux, Bordeaux, France
| | - Garance Perret
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Team HEALTHY, Bordeaux, France
| | - Edwige Pereira
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Team HEALTHY, Bordeaux, France
| | - Annie Fourrier-Réglat
- Univ. Bordeaux, INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.,CHU de Bordeaux, Bordeaux, France
| | - Clothilde Pollet
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Team HEALTHY, Bordeaux, France
| | - Mélina Fatseas
- CHU de Bordeaux, Bordeaux, France.,University of Bordeaux, Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (INCIA), Bordeaux, France
| | - Christophe Tzourio
- CHU de Bordeaux, Bordeaux, France.,Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Team HEALTHY, Bordeaux, France
| | - Amélie Daveluy
- Department of Medical Pharmacology, Centre d'addictovigilance de Bordeaux, Bordeaux, France.,Univ. Bordeaux, INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.,CHU de Bordeaux, Bordeaux, France
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21
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Huỳnh C, Kisely S, Rochette L, Pelletier É, Morrison KB, Li S, Hopkin G, Smith M, Burchill C, Lin E, Asbridge M, Jutras-Aswad D, Lesage A. Measuring Substance-Related Disorders Using Canadian Administrative Health Databanks: Interprovincial Comparisons of Recorded Diagnostic Rates, Incidence Proportions and Mortality Rate Ratios. Can J Psychiatry 2022; 67:117-129. [PMID: 34569874 PMCID: PMC8978214 DOI: 10.1177/07067437211043446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
CONTEXT Assessing temporal changes in the recorded diagnostic rates, incidence proportions, and health outcomes of substance-related disorders (SRD) can inform public health policymakers in reducing harms associated with alcohol and other drugs. OBJECTIVE To report the annual and cumulative recorded diagnostic rates and incidence proportions of SRD, as well as mortality rate ratios (MRRs) by cause of death among this group in Canada, according to their province of residence. METHODS Analyses were performed on linked administrative health databases (AHD; physician claims, hospitalizations, and vital statistics) in five Canadian provinces (Alberta, Manitoba, Ontario, Québec, and Nova Scotia). Canadians 12 years and older and registered for their provincial healthcare coverage were included. The International Classification of Diseases (ICD-9 or ICD-10 codes) was used for case identification of SRD from April 2001 to March 2018. RESULTS During the study period, the annual recorded SRD diagnostic rates increased in Alberta (2001-2002: 8.0‰; 2017-2018: 12.8‰), Ontario (2001-2002: 11.5‰; 2017-2018: 14.4‰), and Nova Scotia (2001-2002: 6.4‰; 2017-2018: 12.7‰), but remained stable in Manitoba (2001-2002: 5.5‰; 2017-2018: 5.4‰) and Québec (2001-2002 and 2017-2018: 7.5‰). Cumulative recorded SRD diagnostic rates increased steadily for all provinces. Recorded incidence proportions increased significantly in Alberta (2001-2002: 4.5‰; 2017-2018: 5.0‰) and Nova Scotia (2001-2002: 3.3‰; 2017-2018: 3.8‰), but significantly decreased in Ontario (2001-2002: 6.2‰; 2017-2018: 4.7‰), Québec (2001-2002: 4.1‰; 2017-2018: 3.2‰) and Manitoba (2001-2002: 2.7‰; 2017-2018: 2.0‰). For almost all causes of death, a higher MRR was found among individuals with recorded SRD than in the general population. The causes of death in 2015-2016 with the highest MRR for SRD individuals were SRD, suicide, and non-suicide trauma in Alberta, Ontario, Manitoba, and Québec. DISCUSSION Linked AHD covering almost the entire population can be useful to monitor the medical service trends of SRD and, therefore, guide health services planning in Canadian provinces.
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Affiliation(s)
- Christophe Huỳnh
- University Institute on Addictions, 49987CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Québec.,Department of Psychiatry and Addiction, University of Montréal, Montréal, Québec, Canada.,School of Psychoeducation, University of Montréal, Montréal, Québec, Canada.,Recherche et Intervention sur les Substances Psychoactives - Québec, Trois-Rivières, Québec, Canada.,54470Institut National de Santé Publique du Québec, Québec, Canada
| | - Steve Kisely
- Department of Community Health and Epidemiology, 12361Dalhousie University, Halifax, Nova Scotia, Canada.,School of Medicine, University of Queensland, Queensland, Australia
| | - Louis Rochette
- 54470Institut National de Santé Publique du Québec, Québec, Canada
| | - Éric Pelletier
- 54470Institut National de Santé Publique du Québec, Québec, Canada
| | | | - Shelley Li
- 151965Alberta Health, Edmonton, Alberta, Canada
| | - Gareth Hopkin
- Institute of Health Economics & University of Alberta, Edmonton, Alberta, Canada.,Health Technology Wales, 1029NHS Wales/GIG Cymru, Cardiff, Wales, UK
| | - Mark Smith
- Manitoba Centre for Health Policy, Rady Faculty of Health Sciences, 50023University of Manitoba, Winnipeg, Manitoba, Canada
| | - Charles Burchill
- Manitoba Centre for Health Policy, Rady Faculty of Health Sciences, 50023University of Manitoba, Winnipeg, Manitoba, Canada
| | - Elizabeth Lin
- 7978Centre for Addiction & Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada
| | - Mark Asbridge
- Department of Community Health and Epidemiology, 12361Dalhousie University, Halifax, Nova Scotia, Canada
| | - Didier Jutras-Aswad
- University Institute on Addictions, 49987CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Québec.,Department of Psychiatry and Addiction, University of Montréal, Montréal, Québec, Canada.,Research Centre, 5622Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Alain Lesage
- University Institute on Addictions, 49987CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Québec.,Department of Psychiatry and Addiction, University of Montréal, Montréal, Québec, Canada.,54470Institut National de Santé Publique du Québec, Québec, Canada.,25443Research Centre of the Montréal Mental Health University Institute, Montréal, Québec, Canada
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22
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Sunami T, So R, Ishii H, Sadashima E, Ueno T, Yuzuriha T, Monji A. A randomized controlled trial of the web-based drinking diary program for problem drinking in multi workplace settings. J Occup Health 2022; 64:e12312. [PMID: 35026038 PMCID: PMC8757573 DOI: 10.1002/1348-9585.12312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 11/25/2021] [Accepted: 12/22/2021] [Indexed: 11/29/2022] Open
Abstract
Objectives To assess the effectiveness of a web‐based brief intervention (BI) program to record daily drinking among people with problem drinking in workplace settings. Methods A two‐armed, parallel‐group, randomized controlled trial were conducted at six workplaces in Japan. After obtaining written consent to participate in the study, workers with an Alcohol Use Disorders Identification Test (AUDIT) score of 8 or higher were randomly assigned into two groups. The participants allocated to the intervention group recorded their daily alcohol consumption for 4 weeks using the program, while those allocated to the control group received no intervention. Outcome measures included the amount of alcohol consumption in past 7 days using the Timeline Follow‐Back method in the program at baseline, 8th week, and 12th week and written AUDIT score at baseline and 12th week. Results Hundred participants were assigned to either the intervention group (n = 50) or control group (n = 50). The results of two‐way repeated measures ANOVA showed a statistically significant interaction between the group and the week factors in the two primary outcomes (number of alcohol‐free days, total drinks) and secondary outcomes (AUDIT score) (p = .04, .02, and .03, respectively). The between‐group effect sizes (Hedges' g; 95% CI) of the outcomes at 12th week were 0.53; 0.13–0.93 (total drinks), 0.44; 0.04–0.84 (AUDIT score), 0.43; 0.03–0.83 (number of alcohol‐free days). Conclusions The web‐based BI program for problem drinking was considered to be effective in reducing alcohol consumption and the AUDIT score in workplace settings.
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Affiliation(s)
- Takashi Sunami
- Saga Prefecture Medical Center Koseikan, Saga, Japan.,Saga University Faculty of Medicine Graduate School of Medical Sciences Department of Psychiatry, Saga, Japan
| | - Ryuhei So
- Okayama Psychiatric Medical Center, Okayama, Japan
| | | | | | - Takefumi Ueno
- National Hospital Organization Hizen Psychiatric Center, Saga, Japan
| | - Takefumi Yuzuriha
- National Hospital Organization Hizen Psychiatric Center, Saga, Japan
| | - Akira Monji
- Saga University Faculty of Medicine Graduate School of Medical Sciences Department of Psychiatry, Saga, Japan
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23
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Kurtuncu M, Kurt A. Energy drink consumption and its relationship to alcohol use disorders and impulsiveness in health sciences students in Turkey. Perspect Psychiatr Care 2022; 58:323-329. [PMID: 33834506 DOI: 10.1111/ppc.12789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/04/2021] [Accepted: 03/10/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE We aimed to examine energy drink (ED) consumption and its relationship to alcohol use disorders and impulsiveness in health sciences students. DESIGN AND METHODS This cross-sectional research was conducted with 1202 health sciences students. Data collection tools were "Energy Drink Consumption Form," "Alcohol Use Disorders Identification Test (AUDIT)," and "Barratt Impulsiveness Scale-11 (BIS-11)." FINDINGS Of the students, 30.6% who used EDs reported doing so in the past year. AUDIT and BIS-11 scores of students with high ED consumption were higher than those with less ED consumption and who do not consume at all (p < 0.05). PRACTICE IMPLICATIONS Education of students in departments of health should include EDs and their drawbacks as part of nutrition or health coursework.
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Affiliation(s)
- Meltem Kurtuncu
- Department of Nursing, Faculty of Health Sciences, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Aylin Kurt
- Department of Nursing, Faculty of Health Sciences, Bartın University Ağdacı Campüs, Bartın, Turkey
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24
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Finelli R, Mottola F, Agarwal A. Impact of Alcohol Consumption on Male Fertility Potential: A Narrative Review. Int J Environ Res Public Health 2021; 19:ijerph19010328. [PMID: 35010587 PMCID: PMC8751073 DOI: 10.3390/ijerph19010328] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/11/2021] [Accepted: 12/23/2021] [Indexed: 12/13/2022]
Abstract
Alcohol abuse disorder is a serious condition, implicating more than 15 million people aged 12 years and older in 2019 in the United States. Ethanol (or ethyl alcohol) is mainly oxidized in the liver, resulting in the synthesis of acetaldehyde and acetate, which are toxic and carcinogenic metabolites, as well as in the generation of a reductive cellular environment. Moreover, ethanol can interact with lipids, generating fatty acid ethyl esters and phosphatidylethanol, which interfere with physiological cellular pathways. This narrative review summarizes the impact of excessive alcohol consumption on male fertility by describing its metabolism and how ethanol consumption may induce cellular damage. Furthermore, the impact of alcohol consumption on hormonal regulation, semen quality, and genetic and epigenetic regulations is discussed based on evidence from animal and human studies, focusing on the consequences on the offspring. Finally, the limitations of the current evidence are discussed. Our review highlights the association between chronic alcohol consumption and poor semen quality, mainly due to the development of oxidative stress, as well as its genotoxic impact on hormonal regulation and DNA integrity, affecting the offspring’s health. New landscapes of investigation are proposed for the identification of molecular markers for alcohol-associated infertility, with a focus on advanced OMICS-based approaches applied to the analysis of semen samples.
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Affiliation(s)
- Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44106, USA;
| | - Filomena Mottola
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy;
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44106, USA;
- Correspondence: ; Tel.: +1-(214)-444-9485
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25
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Herrero-Montes M, Alonso-Blanco C, Paz-Zulueta M, Pellico-López A, Ruiz-Azcona L, Sarabia-Cobo C, Fradejas-Sastre V, Boixadera-Planas E, Parás-Bravo P. Relationship between Depressive Symptoms, Personality, and Binge Drinking among University Students in Spain. J Clin Med 2021; 11:jcm11010053. [PMID: 35011792 PMCID: PMC8745157 DOI: 10.3390/jcm11010053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/10/2021] [Accepted: 12/21/2021] [Indexed: 12/14/2022] Open
Abstract
Binge drinking (BD) is a common practice among college students. Alcohol consumption has been related to depressive symptoms and certain personality factors, although less is known about the relationship of these variables with BD. The aim of this study was to analyze the relationship of BD with depressive symptoms and personality in university students. We performed a cross-sectional study among students (aged 18–30 years) enrolled in the academic year 2018–2019 at the Faculty of Nursing of the University of Cantabria (Spain). Sociodemographic, academic, and alcohol and other drug use information was collected by means of a semi-structured questionnaire. The Beck Depression Inventory-II was used to measure depressive symptomatology and the Neo Five-Factor Inventory was used for personality. A total of 142 participants were included, 88.03% of which were women. Up to 38.03% were classified as BD. Concerning depressive symptoms, 7.41% of BD were at the moderate-severe level compared to 3.41% of non-BD (p = 0.7096). Regarding personality, the median score for extraversion of BD was 35 (Q1 = 29, Q3 = 40), 32 (Q1 = 28, Q3 = 36) in non-BD (p = 0.0062), conscientiousness scored 34 (Q1 = 30.5, Q3 = 38) points in non-BD, 31.50 (Q1 = 27, Q3 = 37) in BD (p = 0.0224). In conclusion, BD students have higher levels of extraversion and lower levels of responsibility than non-BD students. No significant differences were found between the level of depressive symptomatology between BD and non-BD students.
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Affiliation(s)
- Manuel Herrero-Montes
- Department of Nursing, Faculty of Nursing, University of Cantabria, 39008 Cantabria, Spain; (M.H.-M.); (A.P.-L.); (L.R.-A.); (C.S.-C.); (V.F.-S.); (P.P.-B.)
- IDIVAL, Research Nursing Group, 39008 Cantabria, Spain
| | - Cristina Alonso-Blanco
- Department of Physiotherapy, Occupational Therapy, Rehabilitation, and Physical Medicine, University Rey Juan Carlos, 28922 Madrid, Spain;
| | - María Paz-Zulueta
- Department of Nursing, Faculty of Nursing, University of Cantabria, 39008 Cantabria, Spain; (M.H.-M.); (A.P.-L.); (L.R.-A.); (C.S.-C.); (V.F.-S.); (P.P.-B.)
- IDIVAL, GI Derecho Sanitario y Bioética, GRIDES, 39008 Cantabria, Spain
- Correspondence:
| | - Amada Pellico-López
- Department of Nursing, Faculty of Nursing, University of Cantabria, 39008 Cantabria, Spain; (M.H.-M.); (A.P.-L.); (L.R.-A.); (C.S.-C.); (V.F.-S.); (P.P.-B.)
- Cantabria Health Service, 39340 Cantabria, Spain
| | - Laura Ruiz-Azcona
- Department of Nursing, Faculty of Nursing, University of Cantabria, 39008 Cantabria, Spain; (M.H.-M.); (A.P.-L.); (L.R.-A.); (C.S.-C.); (V.F.-S.); (P.P.-B.)
| | - Carmen Sarabia-Cobo
- Department of Nursing, Faculty of Nursing, University of Cantabria, 39008 Cantabria, Spain; (M.H.-M.); (A.P.-L.); (L.R.-A.); (C.S.-C.); (V.F.-S.); (P.P.-B.)
- IDIVAL, Research Nursing Group, 39008 Cantabria, Spain
| | - Víctor Fradejas-Sastre
- Department of Nursing, Faculty of Nursing, University of Cantabria, 39008 Cantabria, Spain; (M.H.-M.); (A.P.-L.); (L.R.-A.); (C.S.-C.); (V.F.-S.); (P.P.-B.)
| | - Ester Boixadera-Planas
- Servei d’Estadística Aplicada, Universitat Autònoma de Barcelona, 08193 Cerdanyola, Spain;
| | - Paula Parás-Bravo
- Department of Nursing, Faculty of Nursing, University of Cantabria, 39008 Cantabria, Spain; (M.H.-M.); (A.P.-L.); (L.R.-A.); (C.S.-C.); (V.F.-S.); (P.P.-B.)
- IDIVAL, Research Nursing Group, 39008 Cantabria, Spain
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26
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Di Lorenzo R, Balducci J, Poppi C, Arcolin E, Cutino A, Ferri P, D'Amico R, Filippini T. Children and adolescents with ADHD followed up to adulthood: a systematic review of long-term outcomes. Acta Neuropsychiatr 2021; 33:283-98. [PMID: 34384511 DOI: 10.1017/neu.2021.23] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The objective is to highlight the clinical and social outcomes among adults who suffered from Attention-Deficit Hyperactivity Disorder (ADHD) in their childhood/adolescence. PubMed, PsycINFO, and Scopus databases were searched for prospective studies published during the last 5 years addressing patients with ADHD in childhood/adolescence followed-up to adulthood. We also included studies published before 2015 reported in other reviews with similar outcomes. Thousand four-hundred and eighty-five studies were identified, but only 39 were included for qualitative analysis and 27 for quantitative analysis. Overall, we found that ADHD persisted into adulthood with a mean rate of 43% and was mainly associated with both substance/alcohol use disorders and antisocial behavior and, less frequently, with anxiety and depressive disorders. The prevalence of persistent ADHD in adulthood reported by studies published after 2011 (55%) was higher than that reported by studies published previously from 1985 to 2011 (34%), suggesting a greater focus on ADHD in recent years. Our results highlight that ADHD can be considered not only a neurodevelopmental disorder, but also a persistent and complex condition, with detrimental consequences for quality of life in adulthood.
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27
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Herrero-Montes M, Alonso-Blanco C, Paz-Zulueta M, Pellico-López A, Ruiz-Azcona L, Sarabia-Cobo C, Boixadera-Planas E, Parás-Bravo P. Relationship of Binge Drinking with Impairments Affecting Memory and Executive Function among University Students: A Cross-Sectional Study in Northern Spain. Int J Environ Res Public Health 2021; 18:11508. [PMID: 34770023 DOI: 10.3390/ijerph182111508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/15/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022]
Abstract
Binge drinking (BD) is a common practice among college students. Alcohol consumption may affect brain structures that continue to develop in early adulthood. The aim of this study was to analyze the relationship of BD with impairments affecting memory and executive function among university students. A cross-sectional study was conducted among students (aged 18–30 years) enrolled for the academic year 2018–2019 at the Faculty of Nursing of the University of Cantabria (Spain). Data collection included sociodemographic and academic information, together with alcohol and drug use information, collected by means of a semi-structured questionnaire. A battery of validated tests was used to gather neuropsychological variables. A total of 142 participants were included, of which 88.03% were women. Up to 38.03% were classified as BD. No differences were found in memory tests. Regarding executive function, better performance in the Stroop Color and Word Test was observed in non-BD but the results were not statistically significant. In conclusion, no relationship was found between memory and executive function and BD, although better performance in executive function, specifically inhibitory control, was observed in non-BD.
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28
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Smyth D, Wilson C, Searby A. Undergraduate nursing student knowledge and attitudes of healthcare consumers with problematic alcohol and other drug use: A scoping review. Int J Ment Health Nurs 2021; 30 Suppl 1:1293-1309. [PMID: 34363429 DOI: 10.1111/inm.12923] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 06/20/2021] [Accepted: 07/29/2021] [Indexed: 11/30/2022]
Abstract
Problematic alcohol and other drug use has a significant societal, personal, and financial burden. Nurses are key in responding to problematic alcohol and other drug use; however, research indicates many nurses hold negative attitudes towards people with substance and alcohol use disorders. Further, little content exists in most undergraduate degrees to address stigma held by new nurses. The objective of this scoping review, structured using Arksey and O'Malley's (International Journal of Social Research Methodology: Theory and Practice, 8 (1), 19-32, 2005) framework, is to examine studies that either explore or attempt to improve the knowledge and attitudes of undergraduate nurses caring for people who use alcohol and other drugs. Our initial search located 610 articles, and after screening, 14 articles were appraised using the Mixed Methods Appraisal Tool (MMAT) and included in this review. Most of the papers appraised were small, localized studies using evaluation methods considered low quality, but showed promising results in addressing stigma and confidence in providing care to people who use alcohol and other drugs. This review indicates that a consistent direction for improving knowledge and attitudes among undergraduate nursing students working with people who use alcohol and other drugs is urgently needed. Further studies of interventions, tested with more rigorous evaluation methodologies, are required to extend existing work in this area.
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Affiliation(s)
- Darren Smyth
- Alcohol and Other Drugs Service, Northern NSW Local Health District, Lismore, New South Wales, Australia
| | - Cate Wilson
- Alcohol and Other Drugs Service, Northern NSW Local Health District, Lismore, New South Wales, Australia
| | - Adam Searby
- Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia
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29
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Lima KHM, Gomes JS, Tucci AM. Electroencephalographic neurofeedback as a tool for reducing harm and risk associated with alcohol use disorder: A critical review. Drug Alcohol Rev 2021; 41:594-602. [PMID: 34580941 DOI: 10.1111/dar.13387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/26/2021] [Accepted: 09/01/2021] [Indexed: 11/28/2022]
Abstract
ISSUES Alcohol use disorder (AUD) causes the highest harms around the world. Many people use alcohol to reduce stress and anxiety, considered as risk factors for AUD. Chronic alcohol use leads to changes in the reward system and the high level of stress may exacerbate neuroendocrine responses. Electroencephalographic (EEG) neurofeedback shows reduction of stress, anxiety and alcohol abuse and it could be an important tool for reducing harm and risk associated with AUD. The aim of this paper is to review the studies that investigated the effects of EEG neurofeedback in subjects with AUD and it proposes to discuss this intervention as a tool for reducing harm and risk in AUD. APPROACH Medline, PsycINFO and LILACS databases were searched and appropriated terms were used. Inclusion criterion was adopted. The year of publication was not limited because of the scarce number of studies. Eighty-two papers returned and eight were included. A critical review was conducted. KEY FINDINGS Most of the papers analysed used the alpha/theta protocol to reduce the 'hyperexcitation' of the nervous system. This protocol provides relaxation, decreases anxiety or stress, prevents alcohol relapse, maintains abstinence and increases the feeling of well-being. IMPLICATIONS EEG neurofeedback has important effects on AUD and anxiety or stress. Studies reinforce the use of EEG neurofeedback as an alternative tool for reducing harm and risk in AUD. CONCLUSION EEG neurofeedback is an intervention to treat AUD, specifically, to reduce harm and risk. However, more randomised studies are necessary to consolidate the effectiveness of the technique.
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Affiliation(s)
| | - July Silveira Gomes
- Interdisciplinary Laboratory of Clinical Neurosciences, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Adriana Marcassa Tucci
- Interdisciplinary Program in Health Sciences, Department of Health, Education and Society, Federal University of Sao Paulo, Sao Paulo, Brazil
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Stasishin D, Schaffer P, Khan Z, Murphy C. Severe metabolic derangement: a case of concomitant diabetic ketoacidosis and beer potomania. BMJ Case Rep 2021; 14:e243486. [PMID: 34373242 PMCID: PMC8354293 DOI: 10.1136/bcr-2021-243486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 11/04/2022] Open
Abstract
Diabetic ketoacidosis (DKA) and hyponatraemia associated with beer potomania are severe diagnoses warranting intensive care level management. Our patient, a middle-aged man, with a history of chronic alcohol abuse and insulin non-compliance, presents with severe DKA and severe hyponatraemia. Correcting sodium and metabolic derangements in each disorder require significant attention to fluid and electrolyte levels. Combined they prove challenging and require an individualised approach to prevent the overcorrection of sodium. Furthermore, management of these conditions lends to the importance of understanding the pathophysiology behind their hormonal and osmotic basis.
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Affiliation(s)
| | - Patrick Schaffer
- Internal Medicine, Doctors Hospital OhioHealth, Columbus, Ohio, USA
| | - Zeryab Khan
- Internal Medicine, Doctors Hospital OhioHealth, Columbus, Ohio, USA
| | - Christie Murphy
- Internal Medicine, Doctors Hospital OhioHealth, Columbus, Ohio, USA
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Thomas A, Cunynghame D, Graham C, Rooke L, Stevenson J. COVID-19: the role of the Royal College of Physicians of Edinburgh. J R Coll Physicians Edinb 2021; 51:S7-S11. [PMID: 34185032 DOI: 10.4997/jrcpe.2021.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The entire College, notably officers and staff, responded with resilience and versatility to COVID-19. We strove to remain at the forefront of medical education during rapid change in both medical care and the scientific evidence that supports it. Every department has had to adapt, indeed evolve, to tackle the pandemic, which affected all aspects of College work, notably education, training, examinations, heritage, policy and public affairs. Several of the resulting changes will provide a strong foundation for the future development of the College. These innovations, especially in the nature and delivery of education, will both extend the reach of the College in years to come, and enhance its relevance. Effective though electronic communication has proved over the last 15 months, however, it cannot replace the social coherence and innate teamwork of a Royal College. So we look forward to re-engaging colleagues in the revitalised College.
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Affiliation(s)
- Angela Thomas
- Royal College of Physicians of Edinburgh, 11 Queen Street, Edinburgh EH2 1JQ, UK,
| | | | | | - Lisa Rooke
- Royal College of Physicians of Edinburgh, Edinburgh, UK
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Berry KL, Sullivan PD, Mansoor AM. Wide pulse pressure and Quincke's pulse in high-output heart failure. BMJ Case Rep 2021; 14:14/7/e241654. [PMID: 34301700 PMCID: PMC8395352 DOI: 10.1136/bcr-2021-241654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 74-year-old man with a history of chronic alcohol use presented with progressive exertional dyspnoea and weight gain. On physical examination, he was noted to have wide pulse pressure, elevated jugular venous pressure, and alternating flushing and blanching of the nail beds in concert with the cardiac cycle, known as Quincke’s pulse. Transthoracic echocardiography demonstrated normal biventricular systolic function and valvular function, but noted a dilated inferior vena cava. Right heart catheterisation revealed elevated filling pressures, high cardiac output and low systemic vascular resistance, consistent with high-output heart failure. Whole blood concentration of thiamine was low, confirming the diagnosis of wet beriberi. The patient abstained from alcohol use and was started on thiamine replacement therapy, resulting in narrowing of the pulse pressure over time and complete resolution of symptoms without the need for diuretic therapy.
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Affiliation(s)
- Katie Lin Berry
- School of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Peter D Sullivan
- Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - André Martin Mansoor
- Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA
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33
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Graves L, Carson G, Poole N, Patel T, Bigalky J, Green CR, Cook JL. Guideline No. 405: Screening and Counselling for Alcohol Consumption During Pregnancy. J Obstet Gynaecol Can 2021; 42:1158-1173.e1. [PMID: 32900457 DOI: 10.1016/j.jogc.2020.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To establish national standards of care for screening and counselling pregnant women and women of child-bearing age about alcohol consumption and possible alcohol use disorder based on current best evidence. INTENDED USERS Health care providers who care for pregnant women and women of child-bearing age. TARGET POPULATION Pregnant women and women of child-bearing age and their families. EVIDENCE Medline, EMBASE, and CENTRAL databases were searched for "alcohol use and pregnancy." The results were filtered for a publication date between 2010 and September 2018. The search terms were developed using Medical Subject Headings terms and keywords, including pre-pregnancy, pregnant, breastfeeding, lactation, female, women, preconception care, prenatal care, fetal alcohol spectrum disorder, prenatal alcohol exposure, drinking behavior, alcohol abstinence, alcohol drinking, binge drinking, alcohol-related disorders, alcoholism, alcohol consumption, alcohol abuse, benzodiazepines, disulfiram, naltrexane, acamprosate, ondansetron, topiramate, cyanamide, calcium carbimide, alcohol deterrents, disease management, detoxification, Alcoholics Anonymous, alcohol counselling, harm reduction, pre-pregnancy care, prenatal care, incidence, prevalence, epidemiological monitoring, and brief intervention. Evidence was included from clinical trials, observational studies, reviews, systematic reviews and meta-analyses, guidelines, and conference consensus. VALIDATION METHODS The content and recommendations in this guideline were drafted and agreed upon by the authors. The Board of Directors of the Society of Obstetricians and Gynaecologists of Canada approved the final draft for publication. The quality of evidence was rated using the criteria described in the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology framework. BENEFITS, HARMS, COSTS Implementation of the recommendations in these guidelines using validated screening tools and brief intervention approaches may increase obstetrical care provider recognition of alcohol consumption and problematic alcohol use among women of child-bearing age and those who are pregnant. It is anticipated that health care providers will become confident and competent in managing and supporting these women so they can achieve optimal health and pregnancy outcomes. SUMMARY STATEMENTS (GRADE RATINGS IN PARENTHESES) RECOMMENDATIONS (GRADE RATINGS IN PARENTHESES).
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Phillips AZ, Rodriguez HP, Kerr WC, Ahern JA. Washington's liquor license system and alcohol-related adverse health outcomes. Addiction 2021; 116:1043-1053. [PMID: 33058384 PMCID: PMC8043979 DOI: 10.1111/add.15234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/08/2020] [Accepted: 08/18/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS In June 2012, Washington state (USA) implemented Initiative 1183, privatizing liquor sales. As a result, off-premises outlets increased from 330 to over 1400 and trading hours lengthened. Increased availability of liquor may lead to increased consumption. This study examines the impact of Initiative 1183 on alcohol-related adverse health outcomes, measured by inpatient hospitalizations for alcohol-related disorders and accidental injuries. It further assesses heterogeneity by urbanicity, because outlets increased most in metropolitan-urban areas. DESIGN County-by-quarter difference-in-difference linear regression models, estimated statewide and within metropolitan/rural strata. SETTING AND PARTICIPANTS Data are from AHRQ Healthcare Cost and Utilization State Inpatient Database 2010-2014 and HHS Area Health Resource File 2010-2014. Changes in the rates of hospitalizations in the 2.5 years following Initiative 1183 in Washington (n = 39 counties) are compared with changes in Oregon (n = 36 counties). MEASUREMENTS County rates of hospitalizations per 1000 residents, including all records with any-listed ICD-9 Clinical Classification Software code denoting an alcohol-related disorder, and all records with any-listed external cause of injury code denoting an accidental injury. FINDINGS The increase in the rate of accidental injury hospitalizations in Washington's metropolitan-urban counties was on average 0.289 hospitalizations per 1000 county residents per quarter greater than the simultaneous increase observed in Oregon (P = 0.017). This result was robust to alternative specifications using a propensity score matched sample and synthetic control methods with data from other comparison states. The evidence did not suggest that Initiative 1183 was associated with differential changes in the rate of hospitalizations for alcohol-related disorders in metropolitan-urban (P = 0.941), non-metropolitan-urban (P = 0.162), or rural counties (P = 0.876). CONCLUSIONS Implementing Washington's Initiative 1183 (privatizing liquor sales) appears to have been associated with a significant increase in the rate of accidental injury hospitalizations in urban counties in that state but does not appear to be significantly associated with changes in the rate of hospitalizations specifically for alcohol-related disorders within 2.5 years.
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Affiliation(s)
- Aryn Z. Phillips
- Center for Healthcare Organizational and Innovation Research, University of California, Berkeley, Berkeley, CA, USA,Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Hector P. Rodriguez
- Center for Healthcare Organizational and Innovation Research, University of California, Berkeley, Berkeley, CA, USA,University of California, Berkeley, School of Public Health, Berkeley, CA, USA
| | | | - Jennifer A. Ahern
- University of California, Berkeley, School of Public Health, Berkeley, CA, USA
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Becker P, Razzouk D. Direct healthcare costs and their relationships with age at start of drug use and current pattern of use: a cross-sectional study. SAO PAULO MED J 2021; 139:18-29. [PMID: 33656124 PMCID: PMC9632499 DOI: 10.1590/1516-3180.2020.0115.r1.21102020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 10/21/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND It is well known that early start of drug use can lead users to psychosocial problems in adulthood, but its relationship with users' direct healthcare costs has not been well established. OBJECTIVES To estimate the direct healthcare costs of drug dependency treated at a community mental health service, and to ascertain whether early start of drug use and current drug use pattern may exert influences on these costs. DESIGN AND SETTING Retrospective cross-sectional study conducted at a community mental health service in a municipality in the state of São Paulo, Brazil. METHODS The relationships between direct healthcare costs from the perspective of the public healthcare system, age at start of drug use and drug use pattern were investigated in a sample of 105 individuals. A gamma-distribution generalized linear model was used to identify the cost drivers of direct costs. RESULTS The mean monthly direct healthcare costs per capita for early-start drug users in 2020 were 1,181.31 Brazilian reais (BRL) (274.72 United State dollars (USD) according to purchasing power parity (PPP)) and 1,355.78 BRL (315.29 USD PPP) for late-start users. Early start of drug use predicted greater severity of cannabis use and use of multiple drugs. The highest direct costs were due to drug dependence combined with alcohol abuse, and due to late start of drug use. CONCLUSIONS Preventive measures should be prioritized in public policies, in terms of strengthening protective factors before an early start of drug use.
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Affiliation(s)
- Paula Becker
- PhD. Occupational Therapist, Department of Psychiatry, Centro de Economia em Saúde Mental (CESM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Denise Razzouk
- MSc, PhD. Psychiatrist and Affiliated Professor, Department of Psychiatry, Centro de Economia em Saúde Mental (CESM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
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Abstract
Although rates of alcohol and other substance use disorders in adolescents have been estimated for decades, little is known about the prevalence, pathways, and predictors of remission and long-term recovery among adolescents. This article provides an integrative review of the literature on youth recovery. A final selection of 39 relevant articles was grouped into five sections: treatment outcomes, special emphasis populations, recovery-oriented systems of care, families, and non-abstinence-based approaches. The review recommends more adolescent research in three basic areas: more research about medication-assisted treatment and recovery as well as harm reduction approaches for adolescents; expansion of research on recovery practices for youth who do not receive treatment due to personal choice or societal disparities; and more life course research, which may begin with adolescent participants and extend across the life span. Additionally, the authors suggest the recovery capital model for adolescents and the neuroscience of addiction may provide additional precision and direction for the study of youth recovery.
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Affiliation(s)
- Andrew J Finch
- Department of Human and Organizational Development, Vanderbilt University, Nashville, Tennessee
| | - Jordan Jurinsky
- Department of Human and Organizational Development, Vanderbilt University, Nashville, Tennessee
| | - Billie May Anderson
- Department of Human and Organizational Development, Vanderbilt University, Nashville, Tennessee
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Abstract
Special emphasis populations in the current context can be defined as groups experiencing health disparities resulting in elevated risk to health, safety, and well-being from drinking alcohol. Individuals from marginalized minority populations often encounter barriers to accessing and receiving effective alcohol treatment due to social inequities and disadvantaged life contexts, which also may adversely affect recovery from alcohol use disorder (AUD). Recovery from AUD often involves the adoption of a stable non-drinking lifestyle (sobriety), increased health and well-being, and increased social connection. Although there has been considerable work on AUD epidemiology among special emphasis populations, little research exists directly examining recovery among racial/ethnic minority populations and/or sexual and gender minority populations. The current narrative review hopes to spark scholarly interest in this critically neglected area. This article opens with a review of special emphasis populations and their alcohol-related risks. Next, definitions of recovery, Alcoholics Anonymous, and culturally adapted recovery models for racial/ethnic minority populations are explored. This is followed by a discussion of factors that may particularly influence recovery among marginalized minority populations. This narrative review concludes with a discussion of research priorities for promoting health equity through studies focused on understanding and supporting recovery from AUD among marginalized minority populations.
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Affiliation(s)
- Eric F Wagner
- Robert Stempel College of Public Health & Social Work, Community-Based Research Institute, and National Institute on Minority Health and Health Disparities (NIMHD) Research Center in a Minority Institution (RCMI), Florida International University, Miami, Florida
| | - Julie A Baldwin
- Center for Health Equity Research and NIMHD RCMI Southwest Health Equity Research Collaborative, Northern Arizona University, Flagstaff, Arizona
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Abstract
A 40-year-old woman presented to the emergency department with epigastric pain and agitation. She recently separated from her husband and was consuming 30 units of alcohol daily for 5 days. She had a history of bipolar affective disorder, borderline personality disorder and alcohol dependence syndrome. Investigations revealed the following: elevated troponin I levels, ST elevation, early Q waves and prolonged QTc. Emergency angiogram confirmed Takotsubo's appearance. Medications with QTc prolongation propensity were held. A multidisciplinary apporach was required. She was discharged 10 days later when medically stabilised. It was later discovered that she died unexpectedly the following month. Takotsubo syndrome is a rare but unique cause of cardiac failure. This case highlights the need to consider the differential of Takotsubo syndrome in people presenting with possible acute ischaemic events, particularly in those with a history of combined emotional and physical stressors and a background history of mood disorder.
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Affiliation(s)
| | - Richard Farrelly
- Liaison Psychiatry, Mater Misericordiae University Hospital, Dublin, Ireland
| | - John Lally
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK.,Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Psychiatry, Mater Misericordiae University Hospital, Dublin, Ireland
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J JM, Kunjumon NC, Ruben JP, Devarbhavi H. Stressful life events, social support, and risk for relapse in relapsed harmful alcohol users in South India: a comparative study between psychiatry and gastroenterology patients. J Addict Dis 2020; 39:125-132. [PMID: 33064059 DOI: 10.1080/10550887.2020.1828536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Previous studies have identified risk factors for relapse in patients with alcohol use disorders in deaddiction or community settings. There are limited studies comparing the stressful life events, social support, and risk of relapse in relapsed harmful alcohol users between psychiatry and gastroenterology departments.Objective: To compare the stressful life events, social support, and risk of relapse in relapsed harmful alcohol users between psychiatry and gastroenterology departments.Methods: Comparative, cross-sectional study design was used in males with harmful alcohol use as defined by AUDIT and with at least one relapse. Presumptive Stressful Life Events Scale, Multidimensional Perceived Social Support Scale, and Alcohol Relapse Risk Scale were used.Results: Severity of alcohol harmful use was significantly higher in psychiatry patients than gastroenterology. Increased number of gastroenterology patients reported "change in their sleeping habits" as an important factor for relapse than psychiatry, which was not significant. Only stimulus-induced vulnerability was significantly increased in psychiatry patients compared to gastroenterology. Social support significantly correlated with the alcohol relapse risk scores in the psychiatry group, while in the gastroenterology, the severity of alcohol harmful use scores significantly correlated with total alcohol relapse risk scores.Conclusions: The individual stressors and the risk for relapse were different between the two groups. There was no difference in social support between the two groups. These findings can have implications for using these factors in relapse prevention strategies by focusing on the factors specifically found in each group. However, these findings have to be studied in a larger community sample.
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Affiliation(s)
- Jobi Mol J
- Department of Psychiatry Nursing, St. Johns College of Nursing, Bengaluru, India
| | | | | | - Harshad Devarbhavi
- Department of Gastroenterology, St. John's Medical College, Bengaluru, India
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Pechholdová M, Jasilionis D. Contrasts in alcohol-related mortality in Czechia and Lithuania: Analysis of time trends and educational differences. Drug Alcohol Rev 2020; 39:846-856. [PMID: 32909686 PMCID: PMC7756221 DOI: 10.1111/dar.13157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/18/2020] [Accepted: 07/29/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS Globally, Czechia and Lithuania are among the top-ranking countries in terms of high alcohol consumption. This study highlights notable contrasts in temporal trends in alcohol-related mortality and identifies country-specific patterns in educational differences. DESIGN AND METHODS The study uses harmonised cause-of-death series from the Human Cause of Death Database. Mortality disparities by education were assessed using census-linked mortality data. Directly standardised death rates were used to estimate levels of national and group-specific mortality. Relative and absolute mortality differences by education were assessed by range-type measures (Poisson regression mortality ratios and rate differences) and Gini-type measures. RESULTS Between 1994-1995 and 2016, the absolute difference between Czechia and Lithuania in terms of alcohol-related age-standardised death rates (per 1 000 000) decreased from 450 for males and 130 for females to 76 in males and 11 in females. In both countries, alcohol-related mortality was markedly higher among persons of lower education levels. Lithuanian males experienced the highest absolute inequalities measured by rate difference between the low and high educated (740 per million), while Lithuanian females showed the most pronounced relative inequalities (6.70-fold difference between low and high educated). The corresponding figures were less than half for Czechia. DISCUSSION AND CONCLUSIONS Reducing educational disparities in alcohol-related mortality within both countries would have a substantial impact on overall levels. Policies aimed at targeting the lowest priced and illegal alcohols and reducing levels of harmful drinking should be a priority, especially in Lithuania.
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Affiliation(s)
- Markéta Pechholdová
- Department of Demography, Faculty of Informatics and Statistics, University of Economics, Prague, Czech Republic
| | - Domantas Jasilionis
- Laboratory of Demographic Data, Max Planck Institute for Demographic Research, Rostock, Germany.,Demographic Research Centre, Faculty of Social Sciences, Vytautas Magnus University, Kaunas, Lithuania
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de Menezes RF, Bergmann A, Thuler LCS. Alcohol consumption does not increase the risk of surgical wound complications in breast cancer patients. Int Wound J 2020; 17:1709-1716. [PMID: 32715640 DOI: 10.1111/iwj.13455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 12/24/2022] Open
Abstract
Alcohol consumption, despite influencing several organic processes, has been scarcely studied regarding the risk of developing surgical wound complications after surgical breast cancer treatment. The aim of this study was to analyse the association between alcohol consumption and the development of surgical wound complications in women undergoing surgical treatment for breast cancer. A prospective cohort study was conducted, comprising 486 women between 40 and 69 years old, interviewed during the preoperative period and followed up for 30 days. The occurrence of seroma, necrosis, surgical site infection (SSI), dehiscence, ecchymosis, and hematoma were considered as outcomes. Alcohol consumption during the 30 days prior to surgery was reported by 20.8% of the patients, with 8.4% being occasional consumers and 12.4% regular consumers. Binge drinking was reported by 10.2% of the women. The presence of surgical wound complications was observed in 65.2%. The most frequent complications were seroma (54.3%), necrosis (17.7%), and SSI (7.8%). No statistically significant association between alcohol consumption and the development of cicatricial complications was observed.
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Affiliation(s)
| | - Anke Bergmann
- Centro de Pesquisa, Instituto Nacional de Câncer-INCA, Rio de Janeiro, Brazil
| | - Luiz Claudio Santos Thuler
- Centro de Pesquisa, Instituto Nacional de Câncer-INCA, Rio de Janeiro, Brazil.,Programa de Pós Graduação em Neurologia, Universidade Federal do Estado do Rio de Janeiro-UNIRIO, Rio de Janeiro, Brazil
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Abstract
This review concerns the current knowledge of melatonin and alcohol-related disorders. Chronobiological effects of ethanol are related to melatonin suppression and in relation to inflammation, stress, free radical scavenging, autophagy and cancer risk. It is postulated that both alcohol- and inflammation-induced production of reactive oxygen species (ROS) alters cell membrane properties leading to tissue dysfunction and, subsequent further ROS production. Lysosomal enzymes are often used to assess the relationships between intensified inflammation states caused by alcohol abuse and oxidative stress as well as level of tissue damage estimated by the increased release of cellular enzymes into the extracellular space. Studies have established a link between alcoholism and desynchronosis (circadian disruption). Desynchronosis results from the disorganization of the body's circadian time structure and is an aspect of the pathology of chronic alcohol intoxication. The inflammatory conditions and the activity of lysosomal enzymes in acute alcohol poisoning or chronic alcohol-dependent diseases are in most cases interrelated. Inflammation can increase the activity of lysosomal enzymes, which can be regarded as a marker of lysosomal dysfunction and abnormal cellular integrity. Studies show alcohol toxicity is modulated by the melatonin (Mel) circadian rhythm. This hormone, produced by the pineal gland, is the main regulator of 24 h (sleep-wake cycle) and seasonal biorhythms. Mel exhibits antioxidant properties and may be useful in the prevention of oxidative stress reactions known to be responsible for alcohol-related diseases. Naturally produced Mel and exogenous sources in food can act in free radical reactions and activate the endogenous defense system. Mel plays an important role in the normalization of the post-stress state by its influence on neurotransmitter systems and the synchronization of circadian rhythms. Acting simultaneously on the neuroendocrine and immune systems, Mel optimizes homeostasis and provides protection against stress. Abbreviations: ROS, reactive oxygen species; Mel, melatonin; SRV, resveratrol; NF-κB, nuclear factor kappa-light-chain-enhancer of activated B cells; ANT, arylalkylamine-N-acetyltransferase; EC cells, gastrointestinal enterochromaffin cells; MT1, melatonin high-affinity nanomolecular receptor site; MT2, melatonin low-affinity nanomolecular receptor site; ROR/RZR, orphan nuclear retinoid receptors; SOD, superoxide dismutase; CAT, catalase; GPx, glutathione peroxidase; GR, glutathione reductase; GSH, reduced form of glutathione; GSSG, oxidized form of glutathione; TAC, total antioxidant capacity; ONOO∙-, peroxynitrite radical; NCAM, neural cell adhesion molecules; LPO, lipid peroxidation; α-KG, α-ketoglutarate, HIF-1α, Hypoxia-inducible factor 1-α, IL-2, interleukin-2; HPA axis, hypothalamic-pituitary-adrenal axis; Tph1, tryptophan hydroxylase 1; AA-NAT, arylalkylamine-N-acetyltransferase; AS-MT, acetylserotonin O-methyltransferase; NAG, N-acetyl-beta-D-glucosaminidase; HBA1c glycated hemoglobin; LPS, lipopolysaccharide; AAP, alanyl-aminopeptidase; β-GR, β-glucuronidase; β-GD, β-galactosidase; LAP, leucine aminopeptidase.
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Affiliation(s)
- Natalia Kurhaluk
- Department of Zoology and Animal Physiology, Institute of Biology and Earth Sciences, Pomeranian University in Słupsk , Słupsk, Poland
| | - Halyna Tkachenko
- Department of Zoology and Animal Physiology, Institute of Biology and Earth Sciences, Pomeranian University in Słupsk , Słupsk, Poland
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Garner AR, Gilbert SE, Shorey RC, Gordon KC, Moore TM, Stuart GL. A Longitudinal Investigation on the Relation between Self-Compassion and Alcohol Use in a Treatment Sample: A Brief Report. Subst Abuse 2020; 14:1178221820909356. [PMID: 32158217 PMCID: PMC7047423 DOI: 10.1177/1178221820909356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 02/05/2020] [Indexed: 11/17/2022]
Abstract
Alcohol misuse is often a chronic problem such that relapses following treatment are common. One potential protective factor for alcohol misuse is self-compassion, which includes self-kindness, feelings of common humanity, and mindfulness when faced with personal suffering and hardships. This study tested the hypothesis that self-compassion, and specifically self-compassion promoting facets including self-kindness, common humanity, and mindfulness, were longitudinally associated with reduced alcohol use among a sample of men and women in substance use disorder treatment (N = 62). Results partially supported the hypothesis, in that only the mindfulness facet of self-compassion was associated with decreased alcohol use over time. Sex and age differences as they related to the positive facets of self-compassion and alcohol use emerged. These findings suggest that positive facets of self-compassion may be beneficial factors to cultivate in alcohol treatment programs.
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44
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de Oliveira LG, Eckschmidt F, Leyton V, de Carvalho HB. Use of Alcohol Mixed with Energy Drinks Increases the Prevalence of Driving Violations among Brazilian Truck Drivers. Subst Use Misuse 2020; 55:1584-1593. [PMID: 32306815 DOI: 10.1080/10826084.2020.1750032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: The use of alcohol mixed with energy drinks (AmED) has been reported to be associated with a variety of unsafe driving practices. Truck drivers are vulnerable to driving violations, particularly because of their engagement in drug use. The use of AmED among these professionals remains unknown. Aim: To estimate the prevalence of AmED use and its association with driving violations among truck drivers. Methods: 684 drivers were recruited in Sao Paulo, Brazil. The use of drugs was reported. Drivers were split into three groups: (a) alcohol abstainers (AA); (b) alcohol-only users (AO); and (c) users of AmED. Intergroup comparisons were performed by polynomial logistic regression (the reference category was AO). We also performed Poisson regression analysis to obtain the prevalence ratio; the significance level was stipulated at 5%. Results: The prevalence of drivers reporting the use of AmED was 16.8%. Users of AmED (a) were younger, (b) were less experienced drivers, (c) had a heavier pattern of alcohol use, (d) used illicit drugs more frequently, and (e) had poorer sleep quality than AO subjects. A higher prevalence of drivers who had arguments or fights while driving (PR = 1.71) and of drivers who drove unbelted (PR = 1.66) ingested AmED than of AO subjects. Conclusions/importance: The use of AmED increased the prevalence of driving violations beyond the risks commonly attributed to alcohol use. We suggest additional investments in preventative measures based on the beverage category and a revision of the work organization of truck drivers to reduce their health and social risks.
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Affiliation(s)
- Lucio Garcia de Oliveira
- Department of Legal Medicine, Ethics and Occupational Health, School of Medicine, University of Sao Paulo (FMUSP), São Paulo, Brasil.,Departament of Neuroscience, School of Medicine, Fundação do ABC, Santo André, Brazil
| | - Frederico Eckschmidt
- Department of Preventive Medicine, School of Medicine, University of São Paulo (FMUSP), São Paulo, Brasil
| | - Vilma Leyton
- Department of Legal Medicine, Ethics and Occupational Health, School of Medicine, University of Sao Paulo (FMUSP), São Paulo, Brasil
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Herrero-Montes M, Alonso-Blanco C, Paz-Zulueta M, Sarabia-Cobo C, Ruiz-Azcona L, Parás-Bravo P. Binge Drinking in Spanish University Students: Associated Factors and Repercussions: A Preliminary Study. Int J Environ Res Public Health 2019; 16:E4822. [PMID: 31801230 DOI: 10.3390/ijerph16234822] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 11/27/2019] [Accepted: 11/28/2019] [Indexed: 01/10/2023]
Abstract
Alcohol consumption is common among young people. We performed a preliminary cross-sectional study among students (aged 18-30 years) enrolled for the academic year 2018-2019 at the Faculty of Nursing, University of Cantabria (Spain). We collected information on psychological and sociographic factors, tobacco and cannabis uses, and levels of physical activity by AUDIT questionnaires and in person interviews. The aim of our study was to assess the potential of binge drinking (BD) to adversely affect memory and executive function. We recruited 103 students, of whom 85% were female. The alcohol use pattern of slightly more than one-half of the total population was classified as BD. Among BD students, one-fourth were smokers, and nearly one-third had tried cannabis. The mean onset for alcohol use was 15.11 years. Despite our relatively small sample size, our results show that there are strong relationships between BD and both smoking and cannabis use.
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46
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Abstract
BACKGROUND Pain and its consequences remain of concern, particularly in high-risk occupations such as the military. Alcohol is a legal and accessible means of self-medication, and risky alcohol use is associated with potentially serious consequences. This exploratory analysis aimed to better understand the association of selected pain diagnoses with risky alcohol use among soldiers returning from deployment. Methods: Analysis of data from active duty soldiers returning from Afghanistan or Iraq deployments in fiscal years 2008-2011 who completed Department of Defense health questionnaires after deployment (n = 267,100). Each questionnaire included self-reported alcohol consumption and items yielding AUDIT-C screening scores. Military Health System data were used to identify diagnoses of pain-related conditions. Results: About 70% of soldiers had none of the selected pain diagnoses either pre- or post-deployment. 10% had incident pain diagnoses (only post-deployment), 7% had persistent pain diagnoses (both pre- and post-deployment), and 13% had remitted pain diagnoses (only pre-deployment). On the AUDIT-C, 39% screened positive for at-risk drinking and 6% were likely to have severe alcohol problems. Half of the respondents reported any binge drinking; 20% at least monthly binge drinking. Logistic regression analyses found reduced odds of risky alcohol use post-deployment in association with incident and persistent pain diagnoses, compared to no pain diagnoses pre- or post-deployment. Conclusions: Pain diagnoses, binge drinking, and risky alcohol use were prevalent among this sample of Army soldiers. An inverse relationship was found between pain diagnosis (incident, persistent) and risky alcohol use post-deployment. Attention should continue to be paid to risky alcohol use in this population, yet these exploratory findings do not suggest that soldiers with the pain diagnoses used in this study are at greater risk. Combat exposure, traumatic brain injury, and psychological health were more important predictors, and should continue to warrant enhanced alcohol screening.
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Affiliation(s)
- Sharon Reif
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| | - Rachel Sayko Adams
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| | - Grant A Ritter
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| | - Mary Jo Larson
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
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47
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Sessa B, Sakal C, O'Brien S, Nutt D. First study of safety and tolerability of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy in patients with alcohol use disorder: preliminary data on the first four participants. BMJ Case Rep 2019; 12:12/7/e230109. [PMID: 31308191 DOI: 10.1136/bcr-2019-230109] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present the preliminary data in an ongoing open-label safety and tolerability proof of concept study exploring the potential role for 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy in treating patients with alcohol use disorder. At this stage, seven participants have completed the full 8-week MDMA-assisted psychotherapy course, including two therapy sessions each with MDMA. This paper focuses on the safety and tolerability of the therapeutic course for the first four participants to complete treatment. Longer-term outcomes of drinking behaviour will be presented later when the full project data are published. Results show all four participants have successfully tolerated the treatment. There have been no serious adverse events related to MDMA, no unexpected physiological responses to the MDMA sessions or changes to blood results or electrocardiograms, measured before and after the 8-week course. We conclude that the treatment is well- tolerated and are making plans to expand the project into a randomised placebo-controlled study.
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Affiliation(s)
- Ben Sessa
- Neuropsychopharmacology, Department of Medicine, Imperial College London, London, UK
| | - Chloe Sakal
- Department of Medicine, Avon and Wiltshire Mental Health Partnership NHS Trust, Bath, UK
| | - Steve O'Brien
- Neuropsychopharmacology, Department of Medicine, Imperial College London, London, UK
| | - David Nutt
- Neuropsychopharmacology, Department of Medicine, Imperial College London, London, UK
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Johnston DC, Mathews WD, Maus A, Gustafson DH. Using Smartphones to Improve Treatment Retention Among Impoverished Substance-Using Appalachian Women: A Naturalistic Study. Subst Abuse 2019; 13:1178221819861377. [PMID: 31312084 PMCID: PMC6614935 DOI: 10.1177/1178221819861377] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 06/13/2019] [Indexed: 11/24/2022]
Abstract
Objectives: Longer retention in treatment is associated with positive outcomes. For
women, who suffer worse drug-related problems than men, social technologies,
which are more readily adopted by women, may offer promise. This
naturalistic study examined whether a smartphone-based relapse-prevention
system, A-CHESS (Addiction-Comprehensive Health Enhancement Support System),
could improve retention for women with substance use disorders in an
impoverished rural setting. Methods: A total of 98 women, age 18 to 40, in southeastern Kentucky and mandated to
treatment, received A-CHESS with intensive outpatient treatment for
6 months. For comparison, data were obtained for a similar but
non-equivalent group of 100 same-age women also mandated to treatment in the
same clinics during the period. Electronic medical record data on
length-of-stay and treatment service use for both groups were analyzed, with
A-CHESS use data, to determine whether those using A-CHESS showed better
retention than those without. Results: Women with A-CHESS averaged 780 service units compared with 343 for the
comparison group. For those with discharge dates prior to the study’s end,
A-CHESS patients stayed in treatment a mean of 410 vs 262 days for the
comparison group. Conclusions: Given associations between retention and positive outcomes, mobile health
technology such as A-CHESS may help improve outcomes among women, especially
in settings where access to in-person services is difficult. The findings,
based on a non-equivalent comparison, suggest the need for further
exploration with rigorous experimental designs to determine whether and to
what degree access to a smartphone with A-CHESS may extend and support
recovery for women.
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Affiliation(s)
- Darcie C Johnston
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Adam Maus
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, USA
| | - David H Gustafson
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, USA.,Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, USA
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49
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Abstract
The authors present the case of an inpatient hospitalized at the Veterans Affairs psychiatric unit diagnosed with Wernicke-Korsakoff syndrome to promote awareness of this prevalent yet often underdiagnosed and undertreated condition. Although Veterans present with a unique predisposition for alcohol abuse, it remains problematic in the general population as well. Analysis from 2000 to 2003 reveals alcohol use in the past month in Veterans at 56.6% and 50.8% in comparable non-Veterans. According to the National Survey on Drug Use and Health, it is estimated that of those who are 18 and older, 86.4% have used alcohol, 26.9% have engaged in binge drinking in the past month, 7% engaged in heavy alcohol use in the past month, and 6.2% (15.1 million) carried the diagnosis of alcohol use disorder., The lifetime prevalence of alcohol abuse in the general population is estimated to be between 4.5% and 13.2%. Primary care providers should maintain a high degree of vigilance in evaluating patients for timely diagnosis and prompt treatment of those suspected to have thiamine deficiency. Indeed, Wernicke's encephalopathy carries a significant level of morbidity and mortality associated with the syndrome, even in cases when it does not present with all of the classic signs. This article aims to raise the primary and ambulatory care provider's ability to recognize the condition, emphasize a low threshold to treat, and highlight current treatment recommendations.
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Affiliation(s)
- Christopher Yoon
- 1 UCSF Fresno Psychiatry Residency Training Program, Fresno, CA, USA
| | - Joanna Gedzior
- 1 UCSF Fresno Psychiatry Residency Training Program, Fresno, CA, USA.,2 Veterans Affairs Central California Health Care System, Fresno, CA, USA
| | - Dwayne DePry
- 1 UCSF Fresno Psychiatry Residency Training Program, Fresno, CA, USA.,2 Veterans Affairs Central California Health Care System, Fresno, CA, USA
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50
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Stapinski LA, Prior K, Newton NC, Deady M, Kelly E, Lees B, Teesson M, Baillie AJ. Protocol for the Inroads Study: A Randomized Controlled Trial of an Internet-Delivered, Cognitive Behavioral Therapy-Based Early Intervention to Reduce Anxiety and Hazardous Alcohol Use Among Young People. JMIR Res Protoc 2019; 8:e12370. [PMID: 30977742 PMCID: PMC6484258 DOI: 10.2196/12370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 01/09/2019] [Accepted: 01/09/2019] [Indexed: 11/13/2022] Open
Abstract
Background The transition to adulthood is a unique developmental period characterized by numerous personal and social role changes and increased opportunities for alcohol consumption. Using alcohol to cope with anxiety symptoms is commonly reported, and young people with anxiety are at a greater risk of hazardous alcohol use and progression to alcohol use disorder. Anxiety and alcohol use tend to fuel each other in an exacerbating feed-forward cycle, leading to difficult-to-treat chronic problems. The peak in onset of anxiety and alcohol disorders suggests this developmental window represents a promising opportunity for early intervention before these problems become entrenched. Objective This study aims to evaluate the efficacy of the Inroads program, a therapist-supported, internet-delivered early intervention for young adults that targets alcohol use, anxiety symptoms, and the interconnections between these problems. Methods A randomized controlled trial will be conducted nationally among young Australians (aged 17-24 years) who experience anxiety symptoms and drink alcohol at hazardous or harmful levels. Participants will be individually randomized on a 1:1 basis to receive the Inroads intervention or assessment plus alcohol guidelines. Participants randomized to the Inroads intervention will receive access to 5 Web-based cognitive behavioral therapy (CBT) modules and weekly therapist support via email and/or phone. The primary outcome assessment will be 8 weeks post baseline, with follow-up assessment 6 months post baseline to determine the sustainability of the intervention effects. Primary outcomes will be the total number of standard drinks consumed in the past month (assessed by the Timeline Follow-Back procedure), severity of alcohol-related harms (assessed by the Brief Young Adult Alcohol Consequences Questionnaire), and anxiety symptoms across multiple disorders (assessed by the Generalized Anxiety Disorder-7). Secondary outcomes will include alcohol outcome expectancies; functional impairment and quality of life; and symptoms of social anxiety, anxious arousal, and depression. Results will be analyzed by intention-to-treat using multilevel mixed effects analysis for repeated measures. Results The study is funded from 2017 to 2020 by Australian Rotary Health. Recruitment is expected to be complete by late-2018, with the 6-month follow-ups to be completed by mid-2019. Results are expected to be published in 2020. Conclusions The study will be the first to evaluate the benefits of a youth-focused early intervention that simultaneously targets anxiety and hazardous alcohol use. By explicitly addressing the interconnections between anxiety and alcohol use and enhancing CBT coping skills, the Inroads program has the potential to interrupt the trajectory toward co-occurring anxiety and alcohol use disorders. The Web-based format of the program combined with minimal therapist support means that if effective, the program could be widely disseminated to reach young people who are not currently able or willing to access face-to-face treatment. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12617001609347; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372748&isReview=true (Archived by WebCite at http://www.webcitation.org/77Au19jmf) International Registered Report Identifier (IRRID) DERR1-10.2196/12370
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Affiliation(s)
- Lexine A Stapinski
- Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia.,The Matilda Centre, University of Sydney, Sydney, Australia
| | - Katrina Prior
- Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia.,The Matilda Centre, University of Sydney, Sydney, Australia
| | - Nicola C Newton
- Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia.,The Matilda Centre, University of Sydney, Sydney, Australia
| | - Mark Deady
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Erin Kelly
- Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia.,The Matilda Centre, University of Sydney, Sydney, Australia
| | - Briana Lees
- Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia.,The Matilda Centre, University of Sydney, Sydney, Australia
| | - Maree Teesson
- Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia.,The Matilda Centre, University of Sydney, Sydney, Australia
| | - Andrew J Baillie
- The Matilda Centre, University of Sydney, Sydney, Australia.,Faculty of Health Sciences, University of Sydney, Sydney, Australia
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